Non-dioxin-like polychlorinated biphenyls (NDL-PCBs) dietary exposure is associated with an increased risk of type 2 diabetes in the European prospective investigation into cancer and nutrition (EPIC) cohort

Xuan Ren; Geneviève Nicolas; Pauline Frenoy; Keren Papier; Conchi Moreno-Iribas; Giovanna Masala; Christina C Dahm; Jie Zhang; Franziska Jannasch; Matthias B Schulze; Elisabete Weiderpass; Paolo Chiodini; Claudia Vener; Paolo Vineis; Alicia K Heath; Fulvio Ricceri; Sandra M Colorado-Yohar; Chloé Marques; Thibault Fiolet; Gianluca Severi; Inge Huybrechts; Francesca Romana Mancini

doi:10.1016/j.diabet.2024.101587

Non-dioxin-like polychlorinated biphenyls (NDL-PCBs) dietary exposure is associated with an increased risk of type 2 diabetes in the European prospective investigation into cancer and nutrition (EPIC) cohort

Diabetes Metab. 2024 Nov 8;50(6):101587. doi: 10.1016/j.diabet.2024.101587. Online ahead of print.

Authors

Xuan Ren¹, Geneviève Nicolas², Pauline Frenoy³, Keren Papier⁴, Conchi Moreno-Iribas⁵, Giovanna Masala⁶, Christina C Dahm⁷, Jie Zhang⁷, Franziska Jannasch⁸, Matthias B Schulze⁹, Elisabete Weiderpass¹⁰, Paolo Chiodini¹¹, Claudia Vener¹², Paolo Vineis¹³, Alicia K Heath¹⁴, Fulvio Ricceri¹⁵, Sandra M Colorado-Yohar¹⁶, Chloé Marques³, Thibault Fiolet¹⁷, Gianluca Severi¹⁸, Inge Huybrechts², Francesca Romana Mancini³

Affiliations

¹ Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Villejuif, France. Electronic address: xuan.ren@inserm.fr.
² Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France.
³ Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Villejuif, France.
⁴ Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
⁵ Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
⁶ Clinical Epidemiology Unit, Institute for cancer research, prevention and clinical network (ISPRO) Florence, Italy.
⁷ Department of Public Health, Aarhus University, Aarhus, Denmark.
⁸ Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
⁹ Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
¹⁰ International Agency for Research on Cancer, Lyon, France.
¹¹ Medical Statistics Unit, University of Campania "Luigi Vanvitelli", Napoli, Italy.
¹² Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Via Venezian, Milan, Italy.
¹³ Environmental Epidemiology MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
¹⁴ Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
¹⁵ Centre for Biostatistics, Epidemiology, and Public Health (C-BEPH), Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy.
¹⁶ Department of Epidemiology, Murcia Regional Health Council, IMIB, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia.
¹⁷ European Food Safety Authority, unit Nutrition and food innovation, Parma, Italy.
¹⁸ Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Villejuif, France; Department of Statistics, Computer Science, Applications "G. Parenti", University of Florence, Florence, Italy.

PMID: 39521120
DOI: 10.1016/j.diabet.2024.101587

Abstract

Aims/hypothesis: The aim of the present study was to investigate the association between dietary exposures to dioxins, dioxin-like polychlorinated biphenyls (DL-PCBs) and non-dioxin-like polychlorinated biphenyls (NDL-PCBs) and the incidence of type 2 diabetes mellitus (T2DM) in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

Methods: This prospective cohort study with a median 11.7 years of follow-up, included 318,416 individuals recruited in 21 centers in eight countries. Dietary intake of dioxins and PCBs was calculated by combining EPIC food consumption data with food contamination data from the European Food Safety Authority (EFSA). To identify incident cases of T2DM, a thorough review of various sources including self-reported information, linkage to primary and secondary care registers, drug registers, hospital admissions, and mortality data was conducted. Associations between dietary intake of dioxins and PCBs and T2DM were evaluated using multivariable Cox regressions.

Results: Higher T2DM risk was observed for higher estimated dietary intake of non-dioxin-like PCBs (NDL-PCBs; HR _{per 1 SD increment} = 1.03 [95 %CI 1.01;1.04], and HR _(Q4_{vs Q1)} = 1.15 [1.08;1.22], P-trend < 0.001). The results were consistent in analyses stratified by gender, body mass index, country, median follow-up, or self-reported hypertension and hyperlipidemia, as well as when adjusting for fat intake. No consistent association was observed between dioxins+DL-PCBs intake and T2DM risk.

Conclusion / interpretation: Results obtained in this large European prospective study indicate a positive and linear association between dietary intake of NDL-PCBs and risk of T2DM. This association remained consistent across various stratified and sensitivity analyses. Further studies are warranted to better understand the biological mechanisms underlying this association.

Keywords: Dietary intake; Dioxin-like PCBs (DL-PCBs); Non-dioxin-like PCBs (NDL-PCBs); Polychlorinated biphenyls (PCBs);Type 2 diabetes.