Jump to ContentJump to Main Navigation
Show Summary Details

Reviews on Environmental Health

Editor-in-Chief: Carpenter, David O. / Sly, Peter

Editorial Board Member: Brugge, Doug / Diaz-Barriga, Fernando / Edwards, John W. / Field, R.William / Hales, Simon / Horowitz, Michal / Maibach, H.I. / Shaw, Susan / Stein, Renato / Tao, Shu / Tchounwou, Paul B.

4 Issues per year


SCImago Journal Rank (SJR) 2015: 0.776
Source Normalized Impact per Paper (SNIP) 2015: 0.676
Impact per Publication (IPP) 2015: 1.795

Online
ISSN
2191-0308
See all formats and pricing
Volume 31, Issue 2 (Jun 2016)

Issues

Association of dioxins, furans and dioxin-like PCBs in human blood with nephropathy among US teens and young adults

Charles J. Everett
  • Corresponding author
  • US Department of Veterans Affairs, Ralph H. Johnson VA Medical Center, 109 Bee Street, Mail Code 151, Charleston, SC 29401, USA
  • Email:
/ Olivia M. Thompson
  • Mayor Joseph P. Riley Institute for Livable Communities, College of Charleston, Charleston, SC, USA
Published Online: 2016-03-16 | DOI: https://doi.org/10.1515/reveh-2015-0031

Abstract

We assessed the association of three chlorinated dibenzo-p-dioxins, a chlorinated dibenzofuran, and four dioxin-like polychlorinated biphenyls (PCBs) in human blood with nephropathy (microalbuminuria or macroalbuminuria) among teens and young adults (12–30 years old) having normal glycohemoglobin (A1c <5.7%). The data were derived from the 1999–2004 National Health and Nutrition Examination Survey (unweighted n=1504, population estimate=38,806,338). In this paper, nephropathy refers to normal A1c with nephropathy. In an all-adult sample (Everett CJ, Thompson OM. Dioxins, furans and dioxin-like PCBs in human blood: causes or consequences of diabetic nephropathy? Environ Res 2014;132:126–31), the cut-offs for these chemicals being considered elevated, were defined as the 75th percentile. Using these same cut-offs again, the proportion of those with one or more of the eight dioxin-like compounds elevated was 9.9%. The four chemicals associated with nephropathy were 1,2,3,6,7,8-hexachlorodibenzo-p-dioxin, PCB 126, PCB 169, and PCB 156. The proportion with one or more of these four dioxin-like chemicals elevated was 3.9% (unweighted n=46) and the odds ratio (OR) for nephropathy was 7.1 [95% confidence interval (CI) 1.8–28.1]. The association was strong among females (OR 17.4, 95% CI 3.4–88.6), but among males there were no cases of nephropathy when one or more of the four dioxin-like chemicals were elevated, and therefore no association. In a separate analysis, elevated toxic equivalency, defined using the eight dioxin-like chemicals (TEQ8), was associated with nephropathy. TEQ8 ≥50.12 fg/g included 2.6% of the sample (unweighted n=28) and had an OR of 5.8 (95% 1.3–25.9) for nephropathy. As found in the analysis of one or more of four dioxin-like chemicals elevated, TEQ8 ≥50.12 fg/g was associated with nephropathy among females (OR 11.9, 95% CI 1.6–87.2), but not males. Trends for least-squares means also differed by gender, but there were no significant differences in mean TEQ8 between normal subjects and those having nephropathy in either males or females. We also evaluated pre-diabetes (A1c 5.7–6.4%) without nephropathy and found no associations when one or more of four dioxin-like compounds were elevated, or when TEQ8 was ≥50.12 fg/g. In this study, associations of dioxin-like chemicals with nephropathy were found among females at an early age. Prospective studies are needed to determine if dioxin-like compounds cause nephropathy, or if these relationships are cases of reverse causation.

This article offers supplementary material which is provided at the end of the article.

Keywords: dioxins; dioxin-like polychlorinated biphenyls; furans; kidney disease; pre-diabetes

References

  • 1.

    Fukami K, Yamagishi S. An overview of diabetic nephropathy. In: Bagchi D, Sreejayan N, editors. Nutritional and therapeutic interventions for diabetes and metabolic syndrome. London: Academic Press, 2012:145–57.

  • 2.

    Everett CJ, Thompson OM. Dioxins, furans and dioxin-like PCBs in human blood: causes or consequences of diabetic nephropathy? Environ Res 2014;132:126–31. [Web of Science]

  • 3.

    Haws LC, Su SH, Harris M, DeVito MJ, Walker NJ, et al. Development of a refined database of mammalian relative potency estimates for dioxin-like compounds. Toxicol Sci 2006;89:4–30.

  • 4.

    Remillard RB, Bunce NJ. Linking dioxins to diabetes: epidemiology and biologic plausibility. Environ Health Perspect 2002;110:853–8.

  • 5.

    Everett CJ. Commentary on nephropathy and longitudinal studies of diabetes and dioxins, furans, and dioxin-like PCBs. Environ Res 2014;134:8. [Web of Science]

  • 6.

    Centers for Disease Control and Prevention (CDC). National Center for Health Statistics. National Health and Nutrition Examination Survey, NHANES 1999–2004. Available at: http://www.cdc.gov/nchs/nhanes.htm.

  • 7.

    Molitch ME, DeFronzo RA, Franz MJ, Keane WF, Mogensen CE, et al. American diabetes association. Nephropathy in diabetes. Diabetes Care 2004;27(Suppl 1):S79–83.

  • 8.

    American Diabetes Association (ADA). Summary of revisions for the 2010 clinical practice recommendations. Diabetes Care 2010;33(Suppl 1):S3.

  • 9.

    Schisterman EF, Whitcomb BW, Louis GM, Louis TA. Lipid adjustment in the analysis of environmental contaminants and human health risks. Environ Health Perspect 2005;113:853–7.

  • 10.

    Van den Berg M, Birnbaum LS, Denison M, De Vito M, Farland W, et al. The 2005 World Health Organization reevaluation of human and mammalian toxic equivalency factors for dioxins and dioxin-like compounds. Toxicol Sci 2006;93:223–41.

  • 11.

    Centers for Disease Control and Prevention (CDC). Z-score data files (ZBMIAGE), 2009. Available at: www.cdc.gov/growthcharts/zscore.htm.

  • 12.

    US Census Bureau. Poverty thresholds. Available at: http://www.census.gov/hhes/www/poverty/data/threshld/index.html.

  • 13.

    US Census Bureau. How the Census Bureau measures poverty. Available at: http://www.census.gov/hhes/www/poverty/about/overview/measure.html.

  • 14.

    SAS Institute Inc. SAS version 9.3, 2015: Cary, North Carolina, USA.

  • 15.

    Centers for Disease Control and Prevention (CDC). Third national report on human exposure to environmental chemicals. Atlanta: National Center for Environmental Health, 2005: NCEH Pub No 05-0570, 467pp.

  • 16.

    Carrero JJ. Gender differences in chronic kidney disease: underpinnings and therapeutic implications. Kidney Blood Press Res 2010;33:383–92. [Web of Science]

  • 17.

    Gluhovschi GH, Gluhovschi A, Anastasiu D, Petrica L, Gluhovschi C, et al. Chronic kidney disease and the involvement of estrogen hormones in its pathogenesis and progression. Rom J Intern Med 2012;50(2):135–44.

  • 18.

    Lee D-H, Porta M, Jacobs Jr DR, Vandenberg LN. Chlorinated persistent organic pollutants, obesity, and Type 2 diabetes. Endocrine Rev 2014;35(4):557–601.

  • 19.

    Swedenborg E, Pongratz I. AhR and ARNT modulate ER signaling. Toxicol 2010;268(3):132–8.

About the article

Corresponding author: Charles J. Everett, PhD, US Department of Veterans Affairs, Ralph H. Johnson VA Medical Center, 109 Bee Street, Mail Code 151, Charleston, SC 29401, USA, E-mail: ; ;


Received: 2015-09-27

Accepted: 2015-12-21

Published Online: 2016-03-16

Published in Print: 2016-06-01


Citation Information: Reviews on Environmental Health, ISSN (Online) 2191-0308, ISSN (Print) 0048-7554, DOI: https://doi.org/10.1515/reveh-2015-0031. Export Citation

Supplementary Article Materials

Comments (0)

Please log in or register to comment.
Log in