Abstract P011: Inverse Relationship between Environmental Contaminant Perfluorooctane Acid and Coronary Heart Disease in Diabetes
Background: The perfluoralkyl acid, perfluorooctanoate is a persistent and widespread environmental contaminant that has been linked to proinflammatory as well as anti-inflammatory changes in both humans and experimental models. Perfluorooctanoate, also called C8, has been positively related to several risk factors for both coronary heart disease and diabetes in the general population. However, the relationship of C8 to coronary heart disease in adults with diabetes remains unexplored. This study examines the association of C8 with coronary heart disease in individuals with diabetes drawn from a large Appalachian population.
Methods: Data on 3943 adults aged ≥20 years with diabetes were obtained from the C8 Health Project, which collected blood samples, self-reported demographics, medical diagnoses, height, and weight in 2005-2006 as part of a legal settlement following perfluorooctanoate (C8) contamination of drinking water in West Virginia and Ohio.
Results: The population was 52% female and 98% White. Mean age and diabetes duration were 58.0 and 10.0 years, respectively. In a logistic regression analysis adjusting for age (OR=1.06, 95% CI=1.06-1.07), diabetes duration (OR=1.01, 95% CI=1.01-1.02), and sex (OR=1.83, 95% CI=1.69-2.13 male vs. female), log-transformed C8 was inversely associated with coronary heart disease (OR=0.88, 95% CI=0.83-0.94). Although the odds of coronary heart disease was nearly twice as great in men, the relationship of C8 with coronary heart disease was similar in each sex (women OR=0.88, 95% CI=0.81-0.96; men OR=0.89, 95% CI=0.82-0.96). In multivariable analyses adjusting for age, diabetes duration, sex, BMI, estimated glomerular filtration rate, HDLc, LDLc, VLDLc, use of lipid medication, log-CRP, insulin, WBC count, and smoking, the inflammatory marker CRP demonstrated a positive association with coronary heart disease (OR=1.12, 95% CI=1.04-1.20), while log-C8 remained inversely associated with coronary heart disease (OR=0.91, 95% CI=085-0.96).
Conclusion: In this cross-sectional analysis of nearly 4000 individuals with diabetes, although the inflammatory marker CRP demonstrated the expected relationship with coronary heart disease, C8 demonstrated an inverse relationship with this largely inflammatory driven disease.
Author Disclosures: B. Conway: None. K. Innes: None.
- © 2015 by American Heart Association, Inc.