Higher prevalence of Diabetes Mellitus related to higher serum dioxin level in an endemic area of dioxin exposure in southern Taiwan

摘要

Background: Diabetes Mellitus (DM) has been found to be related to dioxin in certain populations. Insulin resistant was also found to be correlated to dioxin levels in an area of Tainan, Taiwan where residents were exposed to dioxin released from a factory from 1965 to 1979. Aims: We conducted a study to assess the association between DM and dioxin exposure and to identify risk factors of DM among the residents of the endemic area. Methods: We recruited residents with high levels of dioxin, defined as ≥ 64 pg WHO98-TEQDF/g lipid and performed health examination between October 1, 2008 and December 31, 2009. DM was defined by a fasting serum glucose level ＞ 126 mg/dl or an existing diagnosis of DM. The results were compared to a group of residents whose blood dioxin levels were below 64 pg WHO98-TEQDF/g lipid. Results: Of the 2899 participants, 316 were diagnosed as cases of DM. We observed positive associations between DM and dioxin exposure, age, body mass index (BMI), total cholesterol, triglyceride (TG), low density cholesterol, and high density cholesterol (HDL) (all with p ＜0.05). After adjusting for other factors, we found high dioxin exposure (adjusted odds ratio [AOR] associated with 20-64 pg WHO98-TEQDF/g lipid =1.89, 95% confidence interval [CI]: 1.32-2.71; AOR for ＞64 pg WHO98-TEQDF/g lipid =2.03, 95% C.I.:1.28-3.21), age (AOR for 30-39 years old =6.38, 95% CI: 1.92-21.18; AOR for 40-49 years old =6.93, 95% CI: 2.08-23.02; AOR for 50-59 years old =16.49, 95% CI: 4.99-54.54; AOR for 60-69 years old =22.8, 95% CI: 6.78-76.63; AOR for ≥ 70 years old =22.45, 95% CI: 6.74-74.78), high BMI (AOR for BMI 24-27 =1.89, 95% CI: 1.35-2.64; AOR for BMI 27-30 =1.74, 95% CI: 1.19-2.54; AOR for BMI ＞30 =2.49, 95% CI: 1.64-3.78), high TG (AOR =2.34, 95% CI: 1.76-3.11), and high HDL (AOR =1.35, 95% CI: 1.02-1.78) were independent predictors of DM. Conclusion: DM is correlated with high dioxin levels in the endemic area. It is also related to the age, BMI, TG, and HDL.