scholarly journals Environmental contaminants and the disproportionate prevalence of type-2 diabetes mellitus among Indigenous Cree women in James Bay Quebec, Canada

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aleksandra Zuk ◽  
Eric N. Liberda ◽  
Leonard J. S. Tsuji
Keyword(s):  
Type 2 Diabetes ◽  
First Nations ◽  
Polychlorinated Biphenyl ◽  
Principal Component ◽  
Error Variance ◽  
Indigenous Populations ◽  
Health Study ◽  
Cross Sectional ◽  
High Exposure

AbstractIndigenous populations are disproportionately affected by type 2 diabetes (T2DM) compared to non-Indigenous people. Of importance, the prevalence of T2DM is greater amongst females than males in First Nations communities, in contrast to higher male prevalence reported in non-Indigenous Canadians. Therefore, in this study we extend our previously published work with respect to females, and the potential association between environmental exposures to organochlorine pesticides, such as dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichloroethylene (DDE) to explain the greater prevalence of T2DM among Indigenous females compared to males. Using data from the Multi-Community Environment-and-Health Study, Principal Component Analysis (PCA), examined 9-polychlorinated biphenyl congeners, 7-organic pesticides, and 4-metal/metalloids. Modified Poisson regression with robust error variance estimated adjusted prevalence ratios (PR) and corresponding 95% confidence intervals (95% CI), regressing prevalent T2DM on the newly derived principal components (PC), adjusting for a priori covariates, including parity. We further examined the relationship between high detection concentrations of DDT and tertials of categorized DDE exposures on T2DM among Indigenous Cree women. Among 419 female participants, 23% (n = 95) had physician-diagnosed T2DM. PCA analysis show that DDT and Lead (Pb) loaded highly on the second axis (PC-2), although in opposite directions, indicating the different exposure sources. As previously published, T2DM was significantly associated with PC-2 across adjusted models, however, after further adjusting for parity in this analysis, T2DM was no longer significantly associated with increasing PC-2 scores (PR = 0.88, 95% 0.76, 1.03). Furthermore, we found that the highest detectable levels of DDT, and tertiles of DDE were significantly associated with prevalent T2DM in the fully adjusted model (PR = 1.93, 1.17, 3.19), and (PR = 3.58, 1.10, 11.70), respectively. This cross-sectional analysis suggests organochlorines, specifically, detectable high exposure concentrations of DDT and DDE are associated with prevalent type 2 diabetes, signifying a possible important link between parity and environmental organochlorines pesticides among Indigenous Cree women.

scholarly journals Examining environmental contaminant mixtures among adults with type 2 diabetes in the Cree First Nation communities of Eeyou Istchee, Canada

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Aleksandra M. Zuk ◽  
Leonard J. S. Tsuji ◽  
Evert Nieboer ◽  
Ian D. Martin ◽  
Eric N. Liberda
Keyword(s):  
Type 2 Diabetes ◽  
Principal Component ◽  
Indigenous Communities ◽  
First Nation ◽  
Environmental Contaminant ◽  
Indigenous Populations ◽  
Cross Sectional ◽  
Disease Etiology ◽  
Contaminant Mixtures

Abstract Type 2 diabetes mellitus (T2DM) disproportionately affects Indigenous populations. It is possible that exposure to complex mixtures of environmental contaminants contribute to T2DM development. This study examined the association between complex environmental contaminant mixtures and T2DM among Canadian Indigenous communities from the Eeyou Istchee territory, Quebec, Canada. Using data from the cross-sectional Multi-Community Environment-and-Health Study (2005–2009) Principal Component Analysis (PCA) was used to reduce the dimensionality of the following contaminants: 9-polychlorinated biphenyl congeners; 7-organic pesticides; and 4-metal/metalloids. Following this data reduction technique, we estimated T2DM prevalence ratios (PR) and 95% confidence intervals using modified Poisson regression with robust error variance across derived principal components, adjusting for a priori covariates. For both First Nation adult males (n = 303) and females (n = 419), factor loadings showed dichlorodiphenyltrichloroethane (DDT) and lead (Pb) highly loaded on the second principal component (PC) axis: DDT negatively loaded, and Pb positively loaded. T2DM was significantly associated with PC-2 across all adjusted models. Because PCA produces orthogonal axes, increasing PC-2 scores in the fully adjusted model for females and males showed (PR = 0.84; 95% CI 0.72, 0.98) and (PR = 0.78; 95% CI 0.62, 0.98), respectively. This cross-sectional study suggests that our observed association with T2DM is the result of DDT, and less likely the result of Pb exposure. Further, detectable levels of DDT among individuals may possibly contribute to disease etiology.

Abstract MP037: Plasma Organochlorine Concentration and Risk of Diabetes: the Nurses' Health Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Hongyu Wu ◽  
Kimberly A Bertrand ◽  
Anna L Choi ◽  
Frank B Hu ◽  
Francine Laden ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Polychlorinated Biphenyl ◽  
Plasma Concentrations ◽  
Diabetes Risk ◽  
Health Study ◽  
Blood Draw ◽  
Incident Type ◽  
Increased Risk ◽  
Incident Type 2 Diabetes

Background: Animal experiments have suggested that exposure to persistent organic pollutants (POPs) may lead to increased risk of type 2 diabetes. Although recent human studies supported this hypothesis, evidence from prospective investigations is sparse. Objective: To examine the associations of plasma POP concentrations with risk of incident type 2 diabetes in a prospective setting among US women. Methods: Study population was comprised of participants from two independent nested case-control studies in the Nurses’ Health Study, in which major polychlorinated biphenyl (PCB 118, 138, 153, and 180), p-p'- dichlorodiphenyldichloroethylene (DDE), dichlorodiphenyltrichloroethane (DDT), and hexachlorobenzene (HCB) were measured. A non-parametric approach was used to derive standardized scores for plasma concentrations of lipid-adjusted POPs within each study to minimize between-study variation of the POP measurements. Risk of incident type 2 diabetes during the follow-up period (1990-2008) across the tertiles of the scores was examined. Results: Of 1,120 participants, we identified 48 incident type 2 diabetes cases. After adjusting for covariates assessed at blood draw in 1990, including smoking status, body mass index, and total fish intake, plasma HCB concentration was positively associated with type 2 diabetes risk: odds ratio (OR) (95% confidence interval [CI]) was 2.77 (1.17, 6.55, P for trend =0.022) comparing the highest vs. lowest tertile. Other POPs were not significantly associated with diabetes: the ORs (95% CI) were 1.10 (0.51, 2.34, P for trend =0.81) for p-p'-DDE, 0.93 (0.44, 1.95, P for trend =0.86) for DDT, and 0.88 (0.39, 1.97, P for trend =0.76) for sum of the 4 major PCBs, comparing the extreme tertiles. Conclusion: The significant association of plasma HCB concentration with diabetes risk supports a role of POP exposure in the etiology of type 2 diabetes. More prospective data are warranted to confirm these findings.

scholarly journals The relationship between dietary exposure to persistent organic pollutants from fish consumption and type 2 diabetes among First Nations in Canada

2021 ◽  
Vol 112 (S1) ◽  
pp. 168-182 ◽  
Author(s):  
Lesya Marushka ◽  
Xuefeng Hu ◽  
Malek Batal ◽  
Constantine Tikhonov ◽  
Tonio Sadik ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
First Nations ◽  
Fish Consumption ◽  
Dietary Exposure ◽  
Older Individuals ◽  
Geographical Differences ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
The Relationship

Abstract Objective We previously examined the associations between dietary dichlorodiphenyldichloroethylene (DDE) and polychlorinated biphenyls (PCBs) intake from fish consumption and type 2 diabetes (T2D) prevalence in Ontario and Manitoba. This study aims to further explore the relationship in a regionally representative sample of First Nations adults living on-reserve across Canada. Methods Dietary, health and lifestyle data collected by the cross-sectional First Nations Food, Nutrition and Environment Study (2008–2018) were analyzed. This participatory study included 6091 First Nations adult participants who answered questions on T2D. The consumption of locally caught fish was estimated with a food frequency questionnaire. A total of 551 samples from 96 fish species were collected and analyzed for the presence of DDE and PCBs. The associations between fish and dietary DDE/PCBs intake with self-reported T2D were investigated using multiple logistic regression models adjusted for confounders. Results Dietary exposure to DDE (>2.11 ng/kg/bw) and PCBs (>1.47 ng/kg/bw) vs no exposure was positively associated with T2D with ORs of 2.33 (95% CI: 1.24–4.35) for DDE and 1.43 (95% CI: 1.01–3.59) for PCBs. The associations were stronger among females (DDE OR = 3.11 (1.41–6.88); PCBs OR = 1.76 (1.10–3.65)) and older individuals (DDE OR = 2.64 (1.12–6.20); PCBs OR = 1.44 (1.01–3.91)) as compared with males and younger participants. Also, significant dose-response relationships were found for fish consumption in females only. Conclusion This study confirms our previous findings that dietary DDE/PCBs exposure may increase the risk of T2D. The effect of DDE/PCBs from fish consumption is driven by geographical differences in DDE/PCBs concentrations in fish and by the amount of fish consumed, and is more prominent in females than in males.

scholarly journals Fish consumption is inversely associated with type 2 diabetes in Manitoba First Nations communities

FACETS ◽  
2017 ◽  
Vol 2 (2) ◽  
pp. 795-818 ◽  
Author(s):  
Lesya Marushka ◽  
Malek Batal ◽  
Donald Sharp ◽  
Harold Schwartz ◽  
Amy Ing ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
First Nations ◽  
Fish Consumption ◽  
Fish Intake ◽  
Design Data ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Fish Samples ◽  
Potential Risk Factors

Consumption of fish and n-3 fatty acids (n-3 FAs) has been postulated to prevent type 2 diabetes (T2D).Objective: To explore the association between self-reported T2D and fish consumption, dietary n-3 FAs, and persistent organic pollutants (POP) intake in a regionally representative sample of First Nations (FNs) in Manitoba.Design: Data from the cross-sectional First Nations Food, Nutrition and Environment Study (FNFNES) collected from 706 members of 8 Manitoba FNs in 2010 were used. Household interviews were used to collect social and lifestyle data. The consumption of fish was estimated using a traditional food frequency questionnaire. Fish samples were analyzed for the presence of POP. Multiple logistic regression models adjusted for potential risk factors for T2D were developed.Results: A negative, dose–response relationship was found between fish intake and self-reported T2D. Fish consumptions of 2–3 portions per month and ≥1/week were inversely associated with T2D with odds ratio (OR) values of 0.51 (95% CI: 0.28–0.91) and 0.40 (95% CI: 0.19–0.82), respectively, compared with no fish intake. Similarly, intake of n-3 FAs was negatively associated with T2D (OR = 0.48 (95% CI: 0.30–0.77). Dietary POP intake was not associated with T2D.Conclusion: These findings suggest that the consumption of traditionally harvested fish may have a beneficial effect on T2D in Manitoba FNs.

scholarly journals Incident Type 2 Diabetes Duration and Cancer Risk: A Prospective Study in Two US Cohorts

2020 ◽  
Author(s):  
Yang Hu ◽  
Xuehong Zhang ◽  
Yanan Ma ◽  
Chen Yuan ◽  
Molin Wang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cancer Risk ◽  
Cancer Incidence ◽  
Health Study ◽  
Diabetes Diagnosis ◽  
Cross Sectional ◽  
C Peptide ◽  
Incident Type ◽  
A Prospective Study

Abstract Background The influence of type 2 diabetes mellitus (T2D) duration on cancer incidence remains poorly understood. Methods We prospectively followed for cancer incidence 113 429 women in the Nurses’ Health Study (1978-2014) and 45 604 men in the Health Professionals Follow-up Study (1988-2014) who were free of diabetes and cancer at baseline. Cancer incidences were ascertained by review of medical records. Results In the multivariable-adjusted model incident, T2D was associated with higher risk of cancers in the colorectum, lung, pancreas, esophagus, liver, thyroid, breast, and endometrium. The pooled hazard ratios (HRs) ranged from 1.21 (95% confidence interval [CI] = 1.06 to 1.38) for colorectal cancer to 3.39 (95% CI = 2.24 to 5.12) for liver cancer. For both composite cancer outcomes and individual cancers, the elevated risks did not further increase after 8 years of T2D duration. The hazard ratio for total cancer was 1.28 (95% CI = 1.17 to 1.40) for T2D duration of 4.1-6.0 years, 1.37 (95% CI = 1.25 to 1.50) for 6.1-8.0 years, 1.21 (95% CI = 1.09 to 1.35) for 8.1-10.0 years, and 1.04 (95% CI = 0.95 to 1.14) after 15.0 years. In a cross-sectional analysis, a higher level of plasma C-peptide was found among participants with prevalent T2D of up to 8 years than those without T2D, whereas a higher level of HbA1c was found for those with prevalent T2D of up to 15 years. Conclusions Incident T2D was associated with higher cancer risk, which peaked at approximately 8 years after diabetes diagnosis. Similar duration-dependent pattern was observed for plasma C-peptide. Our findings support a role of hyperinsulinemia in cancer development.

scholarly journals Characterizing risk of type 2 diabetes in First Nations people living in First Nations communities in Ontario: a population-based analysis using cross-sectional survey data

CMAJ Open ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. E178-E183
Author(s):  
Laura C. Rosella ◽  
Kathy Kornas ◽  
Michael E. Green ◽  
Baiju R. Shah ◽  
Jennifer D. Walker ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
First Nations ◽  
Survey Data ◽  
Population Based ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Nations People ◽  
First Nations People

The hefty fetal phenotype hypothesis revisited: high birth weight, type 2 diabetes and gestational diabetes in a Saskatchewan cohort of First Nations and non-First Nations women

2017 ◽  
Vol 10 (1) ◽  
pp. 48-54 ◽  
Author(s):  
R. F. Dyck ◽  
C. Karunanayake ◽  
P. Pahwa ◽  
N. D. Osgood
Keyword(s):  
Type 2 Diabetes ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
First Nations ◽  
Indigenous Populations ◽  
High Birth Weight ◽  
Cox Regression Analysis ◽  
The Relationship ◽  
First Nations Women

Although low birth weight (LBW) increases the risk for type 2 diabetes (T2DM), the relationship between high birth weight (HBW) and T2DM is less definitive and largely confined to North American Indigenous populations. We re-examined the relationship between LBW (<2500 g) and HBW (>4000 g) and both T2DM and gestational diabetes (GDM) among First Nations and non-First Nations women in Saskatchewan. We analyzed new data for female subjects from a 2001 case-control study that led to our hefty fetal phenotype hypothesis. Using survival analysis techniques and a validated algorithm for identifying diabetes in health care administrative data, we followed a 1950–1984 birth cohort of 2003 women until March 31, 2013. Cox regression analysis determined the time to occurrence of first episode of GDM and diagnosis of T2DM by birth weight and ethnicity. First Nations women with HBW demonstrated a greater risk for developing both T2DM [hazard ratios (HR) 1.568; 95% confidence interval (CI) 1.188, 2.069] and GDM (HR 1.468; 95% CI 1.016, 2.121) than those with normal birth weight (NBW). Non-First Nations women with LBW had a greater risk of developing GDM than those with NBW (HR 1.585; 95% CI 1.001, 2.512). HBW is a risk factor for GDM and T2DM among First Nations women. This is likely due to exposure of these women to their own mothers’ diabetic pregnancies or gestational impaired glucose tolerance. This inter-generational amplification of T2DM risk mediated throughprenatalexposures appears to play a substantial role in the epidemic of T2DM among First Nations peoples.

scholarly journals The Prevalence of Metabolic Syndrome and Its Components among People with Type 2 Diabetes in the Ho Municipality, Ghana: A Cross-Sectional Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
James Osei-Yeboah ◽  
William K. B. A. Owiredu ◽  
Gameli Kwame Norgbe ◽  
Sylvester Yao Lokpo ◽  
Jones Gyamfi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
High Blood Pressure ◽  
Abdominal Obesity ◽  
Principal Component ◽  
Cross Sectional ◽  
Predominant Component ◽  
Study Population

The cooccurrence of diabetes mellitus and metabolic syndrome potentiates the cardiovascular risk associated with each of the conditions; therefore characterizing metabolic syndrome among people with type 2 diabetes is beneficial for the purpose of cardiovascular disease prevention. This study aims at evaluating the prevalence of metabolic syndrome and its components among 162 patients with type 2 diabetes attending the diabetic clinic of the Ho Municipal Hospital, Ghana. Data obtained included anthropometric indices, blood pressure, serum lipids, glucose, and sociodemographics and clinical information. The overall prevalence of metabolic syndrome among the study population was 43.83%, 63.58%, and 69.14% using the NCEP-ATP III, the WHO, and the IDF criteria, respectively. The most predominant component among the study population was high blood pressure using the NCEP-ATP III (108 (66.67%)) and WHO (102 (62.96)) criteria and abdominal obesity (112 (69.14%)) for IDF criteria. High blood pressure was the most prevalent component among the males while abdominal obesity was the principal component among the females. In this population with type 2 diabetes, high prevalence of metabolic syndrome exists. Gender vulnerability to metabolic syndrome and multiple cluster components were skewed towards the female subpopulation with type 2 diabetes.

Abstract 21: Deciphering the Plasma Proteome of Type 2 Diabetes

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Mohamed A Elhadad ◽  
Christian Jonasson ◽  
Cornelia Huth ◽  
Rory Wilson ◽  
Barbara Thorand ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Growth Hormone Receptor ◽  
Complex Disease ◽  
Causal Effect ◽  
Causal Effects ◽  
Sex Hormone Binding Globulin ◽  
Health Study ◽  
Oral Glucose ◽  
Cross Sectional

Introduction: With an estimated prevalence of 425 million individuals, type 2 diabetes (T2D) is a major challenge to health care systems worldwide. It is a multifactorial complex disease characterized by insulin resistance and hyperinsulinemia, and involves widespread complications. We performed hypothesis-free association and Mendelian randomization (MR) based causal inference analyses of T2D, investigating 1,100 plasma proteins in cross-sectional and longitudinal settings. Methods: The population-based cohort studies KORA (Cooperative health research in the Region of Augsburg) and HUNT3 (Third wave of the Nord-Trøndelag Health Study) were used for discovery and replication, respectively. Proteins were quantified using the SOMAscan proteomics platform in 999 KORA and 1007 HUNT participants. After quality control, we log2-transformed and (0,1)-standardized the proteomics data. We validated T2D using clinical and oral glucose tolerance test data in KORA, and clinical data only in HUNT3. We computed logistic regression models adjusted for age, sex, body mass index, smoking status and hypertension status and accounted for multiple testing using the Benjamini-Hochberg false discovery rate (FDR) method (FDR<0.05). Subsequently, we used two-sample bi-directional MR to infer the causal relationship between T2D and the replicated proteins. Results: The cross-sectional analysis with prevalent T2D (KORA 110 cases and HUNT 149) yielded 24 replicated proteins, of which the three yielding the highest odds ratios were aminoacylase 1, complement C2 and plasma protease C1 inhibitor. Longitudinal analysis with incident T2D (KORA 74 cases and HUNT 103) yielded three replicated proteins namely aminoacylase-1, growth hormone receptor and insulin like growth factor binding protein 2. The MR analysis testing the causal effect of T2D on the replicated proteins, using 120 SNPs as instrumental variables (IV), yielded nominally significant p-values (p<0.05) for cathepsin Z and renin. The estimated causal effects went into the same direction as the results for both proteins suggested. In the MR analyses testing the causal effects of the proteins on T2D, using cis-acting SNPs as IVs, sex hormone-binding globulin (SHBG) had nominally significant causal effect that went into the same direction as its result suggested. None of the MR analysis results was statistically significant at the FDR threshold. Conclusion: Using an aptamer-based technique, we replicated previously reported prevalent and incident T2D-protein associations, including SHBG, complement C2 and renin as well as identified novel ones, like aminoacylase-1. Causality analyses using MR identified SHBG as a potential protein directly involved in the pathogenesis of T2D, and suggested a causal effect of T2D on both cathepsin Z and renin, both known to have roles in the pathophysiological pathways of cardiovascular disease.

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