Human studies addressing exposure to OC compounds and obesity (n = 25)
| Authors, year | Country | Study design, quality | Study objective | Source population | Sex and age | Sample size | Sample, compounds (DR) and method | Outcomes | Adjustment for confounding factors | Main findings |
| Hue et al, 200789 | Canada | Cross-sectional, 5 | To investigate the association between [plasma OC compounds] and obesity | NS | Male and female, steady body weight, control 38.8±9.4 years (n=16), obese 38.6±7.6 years (n=19), morbidly obese 44.3±9.2 years (n=18) | 53 | Plasma 14 PCBs (28, 52, 99, 101, 105, 118, 128, 138, 153, 156, 170, 180, 183, 187) (NS) 11 chlorinated pesticides (β-HCH, HCB, p,p’-DDE, trans-nonachlor, oxychlordane, cis-nonachlor, aldrin, α-chlordane, γ-chlordane) (NS) p,p’-DDT (7.5%) mirex (22.4%) GC-MS | BMI | Age | [Total plasma OC compounds] not correlated with BMI |
| Dhooge et al, 201053 | Belgium | Cross-sectional, 6 | To investigate the association between exposure to pollutants and body size | Selection from a stratified clustered multistage design, as a random sample of adolescents and adults residing in the study area | Male and female, 14–15 years and 50–65 years | 1679 adolescents, 1583 adults | Serum PCB 118, 138, 153, 180, HCB, p,p-DDE, CALUX analysis of the dioxin fraction of dioxin-like activity in plasma (NS) GC-ECD | BMI | Adolescents: blood lipids, age, height of father and mother, smoking, sexual maturation (Tanner), food intake. Adults: blood lipids, age, smoking, food intake | [Serum HCB, sum PCB 118, 153, 180] negatively associated with BMI, and [PCB118] positively associated with BMI in adolescents [Serum sum PCB 138, 153, 180] negatively associated with BMI, and [serum HCB, p,p’-DDE and PCB118, dioxin fraction] positively associated with BMI in adult men [Sum PCB138, 153, 180] negatively associated with BMI, and [HCB, p,p’-DDE and PCB118] positively associated with BMI in adult women |
| Elobeid et al, 201023 | USA | Cross-sectional, 5 | To investigate the association between [serum OC compounds] and BMI/WC | General population, NHANES 1999–2002 | Male and female, 6 years to > 40 years | 2464 | Serum HpCDD, OcDD, oxychlordane, trans-nonachlor, p,p’-DDT (NS) GC-MS | BMI, WC | Serum TC and TG | [Serum p,p’-DDT] positively associated with WC in all subjects [Serum oxychlordane and HpCDD] positively associated with WC in subjects with detectable levels of these compounds [Serum OcDD] increased with higher WC and BMI [Serum trans-nonachlor] decreased with higher BMI |
| Dirinck et al, 201154 | Belgium | Cross-sectional, 4 | To investigate the association between [serum OC compounds] and BMI, WC, fat mass and HOMA-IR | Outpatients from the weight management clinic of the Department of Endocrinology, Diabetology and Metabolism of the Antwerp University Hospital (obese); hospital staff and volunteers (normal-weight controls) | Male and female, 21–60 years (median 40 years) | 144 | Serum PCB (153, 138, 180, 170, sum PCB), pp-DDE, b-HCH (NS) GC-MS | BMI, WC, FM (total abdominal, visceral abdominal, subcutaneous abdominal), FM% | None | [Serum PCB 153, 180, 180, sum PCB] negatively correlated with BMI, WC, FM%, total and subcutaneous abdominal adipose tissue [Serum b-HCH] positively correlated with BMI, WC, FM%, and total and subcutaneous abdominal adipose tissue |
| Lee et al, 201124 | USA | Cohort, 7 | To investigate the association between [serum OC compounds] and adiposity, dyslipidaemia, and insulin resistance over 18 years | Non-diabetic controls from the Coronary Artery Risk Development in Young Adults study | Male and female, 18–30 years at baseline (27.2±3.3 years) | 90 | Serum 9°C pesticides (44%–100%), 35 PCB congeners (7%–100%) GC/ID-HRMS | BMI | Age, sex, race, TG, TC, HDL-C, HOMA-IR, baseline BMI | [Serum p,p’-DDE] and PCBs with > 7 chlorines predicted higher BMI after 18 years (inverted U-shaped curve across quartiles) |
| Twum et al, 201125 | USA | Cross-sectional, 6 | To investigate the association between [urinary OC compounds] and obesity | General population, NHANES 2003–2004, NHANES 2005–2006 | Male and female, 6–19 years | 6770 | Urine 2,4-DCP (92%), 2,5-DCP (99%), ortho-phenylphenol (<40%) HPLC-MS | BMI, obesity (BMI > p95 for sex and age) | Age, gender, race, income, total fat intake | [Urinary 2,5-DCP] associated with childhood obesity |
| Lee et al, 201255 | Sweden | Cross-sectional, 6, and prospective, 7 | To investigate the association between [plasma POPs] and prevalent abdominal obesity, cross-sectionally and prospectively | Participants from the Prospective Investigation of the Vasculature in Uppsala Seniors | Male and female, 70 years (at baseline) | 970 (cross-sectional) 511 (prospective) | Plasma 17 PCB (98.7%–100%) 5°C pesticides (p,p’-DDE, trans-nonachlor, HCB, chlordane, cis-chlordane(3.4–100%)) HRGC-HRMS | WC, abdominal obesity (WC > 102 cm for men and > 88 cm for women) | Total calorie intake, exercise, smoking, alcohol consumption, TG, TC | [Plasma less chlorinated PCBs, p,p’-DDE and dioxin] associated with abdominal obesity (inverted U-shape relation, particularly in women) [Plasma highly chlorinated PCB] inversely associated with abdominal obesity Similar but weaker associations between [plasma POPs] and development of abdominal obesity after 5 years |
| Arrebola et al, 201287 | Bolivia | Cross-sectional, 3 | To describe [serum and adipose tissue OC compounds] in an urban adult population from Bolivia and its association with demographic characteristics | Subjects undergoing non-cancer-related surgery at a general hospital in Santa Cruz de la Sierra | Male and female, >16 years (31.4±12.6 years) | 112 | Serum and adipose tissue p,p’-DDT (50%), p,p’-DDE (93%), HCB (21%), PCB congeners 138,153,180 (56%–80%) GC-ECD | BMI | None | [Serum and adipose tissue OC compounds] not correlated with BMI |
| Ben et al, 201388 | Tunisia | Cross-sectional, 4 | To describe [serum OC compounds] in the general population of Bizerte, Tunisia, and investigate its association with age, gender and BMI | Subjects visiting the Regional Hospital of Bizerte, in Tunisia | Male and female, >18 years, not pregnant and without critical or heart disease | 113 | Serum HCB, p,p’-DDE, PCB 153, PCB 180 (100%) Dieldrin, heptachlor, PCB 18, 28, 31, 52, 44 (0%) b-HCH, lindane, p,p’-DDD, p,p’-DDT, PCB congeners 101, 149, 118, 138, 194 (1.7%–95.6%) GC-MS | BMI | Serum lipids | [Serum OCPs and PCB congeners 153, 138, 180 and sum PCB] not associated with BMI |
| Lankester et al., 201343 | USA | Cross-sectional, 7 | To investigate the association between [urinary TCS] and BMI | General population, NHANES 2003–2003 | Male and female, >20 years | 4037 | Urine TCS (75%) HPLC-MS/MS | BMI | Survey year, sex, age, race, poverty index ratio, urinary BPA, urinary cotinine | [Urinary TCS] positively associated with increased BMI |
| Roos et al, 201360 | Sweden | Cross-sectional, 6 | To investigate the association between [plasma OC compounds] and abdominal obesity | Subjects aged 70 years randomly chosen from the register of community living from Uppsala, Sweden | Male and female, 70 years | 1016 | Plasma 16 PCBs, p,p’-DDE, HCB, TNC (>95.5%); OcDD (80.6%); cis-chlordane, trans-chlordane (<10%) HRGC-HRMS | BMI, VAT/SAT ratio (determined by MRI) | Gender, education, exercise habits, smoking | [Plasma less chlorinated PCBs, p,p’-DDE, HCB, TNC] positively associated with both VAT and SAT [Plasma highly chlorinated PCBs] inversely related to both VAT and SAT [Plasma PCB189] correlated with VAT/SAT ratio in an inverted U-shaped manner |
| Buser et al, 201426 | USA | Cross-sectional, 7 | To investigate the association between [urinary POP] and BMI z-score, WC and obesity | General adult population, NHANES 2007–2008 and 2009–2010 | Male and female, 6–19 years (mean 12.56±0.1 years) | 1298 | Urine 2,5-DCP (98.5%), 2,4-DCP (90%), TCS (79%) HRGC-HRMS | BMI z-score, WC, overweight (BMI p85–p95), obesity (BMI > p95) | Age, sex, race/ethnicity, calorie intake, television and video game and computer usage (6–11 years), physical activity (12–19 years), serum cotinine, poverty income ratio, urinary creatinine | [Urinary 2,4-DCP, 2,5-DCP] positively associated with BMI z-score, WC and obesity. After stratification for age, the associations remained significant only in adolescents. |
| Wei et al, 201427 | USA | Cross-sectional, 7 | To investigate the association between [urinary POP] and obesity | General adult population, NHANES 2005–2006, NHANES 2007–2008 | Male and female, 20–85 years | 2931 | Urine 2,4-DCP (92.6%), 2,5-DCP (99%) HPLC-MS | BMI, obesity (BMI > 30 kg/m2), non-obese (< 30 kg/m2) | Age, gender, race, income, education, total fat intake, physical activity, urinary creatinine | [Urinary 2,5-DCP] positively associated with obesity |
| Li et al, 201544 | USA | Cross-sectional, 6 | To investigate the association between [urinary TCS] and obesity traits | General adult population, NHANES 2003–2010 | Female and male, children (6–19 years) and adults (>20 years) | 2898 children 2066 adults | Urine TCS (77%–79%) ID-HPLC-MS/MS | BMI and WC | Race/ethnicity, socioeconomic status, serum cotinine, (urinary BPA) | [Urinary TCS] inversely associated with BMI and WC in children and adults |
| Zong et al, 201545 | USA | Cross-sectional, 7 | To investigate the association between [serum OC compounds] and body fat | General adult population, NHAES 1999–2004 | Female and male, >20 years | 2358 | Serum p,p’-DDE, p,p’-DDT, b-HCH, HxCDD, OcDD, HpCDF, PCB (126, 138, 153, 169, 170, 180, 187, 194, 196,199) (30%–69%) HRGC-HRMS | FM% (DXA) | Serum lipids, gender, age, ethnicity, education, physical activity, smoking status, alcohol consumption, history of parity and lactation | [Serum b-HCH, HpCDF, OcDD, PCB126] positively associated with trunk FM% (correlations stronger in subjects >40 years); [serum PCB 138, 153, 169, 170, 180, 187, 194, 196] inversely correlated with FM% |
| Tang-Péronard et al, 201556 | Denmark | Cohort, 7 | To investigate the association between [serum POP] at 8–10 years of age and changes in measures of obesity at 14–16 years and 20–22 years | Children form the European Youth Heart Study, Danish component | Male and female, 8-10 years at baseline | 392 | Serum PCB sum (PCB 138, 153, 180), p,p’-DDE, HCB (NS) GC | BMI z-score, WC, %BF | Baseline obesity, breast feeding, maternal educational level, maternal smoking, maternal BMI, pubertal status, physical fitness (maximal work test), dietary intake | [Serum POP] not associated with subsequent changes in measures of obesity |
| Geens et al, 201549 | Belgium | Cross-sectional, 6 | To investigate the association between [urinary TCS] and anthropometric data and serum thyroid hormones, to evaluate the dynamics of [urinary TCS] during 1 year of weight loss, to estimate daily TCS intake and investigate daily intake differences during weight loss and to evaluate variations in exposure sources according to treatment method for weight loss (bariatric surgery/diet) | OW and obese adults from the Endorup trial (Antwerp University Hospital); lean controls from hospital staff and volunteers | Female and male, >18 years | 194 | Urine TCS (>90%) HPLC-MS | BMI, WC | Age, gender, weight loss, urinary creatinine | No difference between [urinary TCS] in obese and lean subjects at baseline No significant change of [urinary TCS] during weight loss |
| Xue et al, 201571 | India | Cross-sectional, 6 | To investigate the association between [urinary POPs] and obesity | Endocrinology Outpatient Department of the Amrita Institute of Medical Sciences, Kochi, India | Male and female, 2–14 years | 103 (49 OW or obese and 27 normal-weight healthy controls) | Urine TCS (100%) LC-MS | BMI (OW defined by BMI > p85 and obesity defined by BMI > p95) | Age, sex, family income, parent education, physical activity, urinary creatinine | (Urinary TCS) not associated with obesity |
| Lee et al, 201674 | South Korea | Cohort, 8 | To investigate the association between [serum OC compounds] and prospective change of metabolic components of metabolic syndrome | Subjects from the Ewha Birth & Growth Cohort study | Female and male, 7–9 years | 214 (158 completed follow-up) | Serum PCB (52, 101, 118, 138, 153, 156, 180), marker PCB (sum 28, 52, 101, 138, 153, 180), dioxin-like PCB (sum 77, 81, 114, 105, 126, 123, 156, 157, 169, 167, 189), nonachlor, HCB, b-HCH, p,p’-DDT, p,p’-DDE) (61.68%–99.53%) PCB (1, 3, 4, 15, 19, 28, 37, 77, 81, 104, 105, 114, 123, 126, 155, 157, 167, 169, 188, 189, 202, 205, 206, 208), oxychlordane, chlordane, heptachlor, heptachlor epoxide, a-HCH, g-HCH, d-HCH, o, p’-DDT, p,p’-DDD, o,p’-DDD, o,p’-DDE (NS) GC-MS | BMI, BMI z-score | Gender, age, monthly household income, baseline BMI, serum lipids | No association between (serum OC compounds) and change in BMI after 1 year |
| Deierlein et al, 201736 | USA | Cohort, 9 | To investigate the association between [urinary EDCs] and changes in adiposity measurements after 8 years, in elementary-school-aged girls | Subjects from the puberty cohort studies of the Breast Cancer and Environment Research Programme | Female, 6–8 years | 1017 | Urine 2,5-DCP (>80%) TCS (>80%) HPLC-MS | BMI, WC, BF% (bioelectrical impedance analysis) | Age, urinary creatinine, race/ethnicity, site of study, caregiver education, early puberty, baseline weight | (Urinary 2,5-DCP and TCS) associated with increase in adiposity measurements after 8 years |
| Harmouche et al, 201780 | Lebanon | Cross-sectional, 6 | To investigate serum levels of six indicator PCBs and differences in PCBs levels by gender, age and BMI | Students and employees of Saint Joseph University | Female and male, 17–65 years | 316 | Serum PCB 28, 52, 101, 138, 153, 180 (50%–60%) GC-ECD | BMI, BF% (bioelectrical impedance analyser) | Total serum lipids, age, gender, smoking status, dairy product, fish and shellfish consumption | (Serum sum PCB) associated with OW and OB in and inverted-U shaped manner |
| Henriquez-Hernandez et al, 201761 | Spain | Cross-sectional, 4 | To investigate the association between exposure to POPs and OB and type two diabetes | Subjects from the Canary Islands Nutrition Survey | Female and male, >18 years | 429 | Serum p,p′-DDT (<50%), DDE (<50%), DDD (<50%), p,p′-DDE (85.8%), p,p′-DDD (<50%), aldrin (64.1%), dieldrin (<50%), endrin (68.3%), HCHα (88.1%), HCHβ (<50%), HCHδ (<50%), HCHγ (55.7%) PCBs 153 (77.2%), 180 (85.1%), 28, 52, 77, 81, 101, 105, 114, 118, 123, 126, 138, 153, 156, 157, 167, 169, 180, 189 (<50%) GC-ECD (OCPs), GC-MS (PCBs) | BMI, waist-to-hip ratio | None | (Serum p,p’-DDE) higher among OW and OB subjects |
| Karlsen et al, 201762 | Denmark | Cross-sectional, 6 | To investigate the association between [POPs] and obesity | Subjects from the National Hospital of the Farol Islands | Female and male, 5 years | 349 | Serum sum PCB 138, 153, 180 (100%), HCB (100%), p,p’DDE (100%) GC-ECD | BMI z-score, OW (> p85) | Serum lipids, maternal nationality, age at delivery, prepregnancy BMI, smoking during pregnancy, child’s gender, exclusive breastfeeding duration, child’s fish intake at age 5 years | (Serum OC compounds) inversely associated with BMI z-score |
| Parastar et al, 201781 | Iran | Cross-sectional, 2 | To investigate the association between [urinary pesticides] and obesity in children and adolescents | Selection from households in different areas of Isfahan, Iran | Male and female, 6–18 years | 242 | Urine 2,4-DCP (94.6%), 2,5-DCP (95%), 2,4,5-TCP (85.1%), 2,4,6-TCP (38%) GC-MS | BMI, BMI z-score, WC | Urinary creatinine, physical activity, fasting blood sugar, blood pressure, TC, HDL-C, LDL-C | [Urinary 2,5-DCP] positively associated with BMI z-score and WC; [urinary 2,4,5-TCP] positively associated with WC; [urinary 2,5-DCP] associated with obesity |
| Kalloo et al, 201842 | USA | Cross-sectional, 8, and prospective, 8 | To investigate the association between [urinary TCS] and adiposity in children | Participants from the Health Outcomes and Measures of the Environment Study, Cincinnati | Male and female, <8 years | 218 | Urine TCS (NS) HPLC-MS/MS | BMI, WC, %BF | Maternal variables: race, age, education, marital status, household income, age at delivery, BMI, prenatal vitamin use, delivery method, breast feeding, parity, gestational diabetes, hypertensive disorders, urinary cotinine Child variables: age, screen time, diet, physical activity | No association between [urinary TCS] at the ages of 1–5 and 8 and measures of adiposity at the age of 8 years |
AT, adipose tissue; BF, body fat; BMI, body mass index; BPA, bisphenol A; CALUX, chemical activated luciferase gene expression; DCP, dichlorophenol; DDD, dichlorodiphenyldichloroethane; DDE, dichlorodiphenyldichloroethylene; DDT, dichlorodiphenyltrichloroethane; DR, detection rate; DXA, dual-energy X-ray absorptiometry; EDC, endocrine disrupting chemical; FM, fat mass; GC-ECD, gas chromatography–electron capture detector; GC-ID/HMRS, gas chromatography–isotope dilution/high-resolution mass spectrometer; GC-MS, gas chromatography–mass spectrometry; HCB, hexachlorobenzene; HCH, hexachlorohexane; HDL-C, high-density lipoprotein cholesterol; HOMA-IR, homeostatic model assessment-insulin resistance; HpCDD, heptachlorodibenzo-p-dioxin; HpCDF, heptachlorodibenzofuran; HPLC-MS, high-performance liquid chromatography–mass spectrometry; HPLC-MS/MS, high-performance liquid chromatography-tandem mass spectrometry; HRGC-HRMS, high-resolution gas chromatography–high-resolution mass spectrometry; HxCDD, hexachlorodibenzo-p-dioxin; HxCDF, hexachlorodibenzofuran; ID-HPLC-MS/MS, isotope dilution-high-performance liquid chromatography-tandem mass spectrometry; LC-MS, liquid chromatography-mass spectrometry; LDL-C, low density lipoprotein cholesterol; NHANES, National Health and Nutrition Examination Survey; NS, not stated; OB, obesity; OC, organochlorine; OcDD, octachlorodibenzo-p-dioxin; OCP, organochlorine pesticide; OW, overweight; PCB, polychlorinated biphenyl; PeCDF, pentachlorodibenzofuran; POPs, persistent organic pollutant; SAT, subcutaneous adipose tissue; TC, total cholesterol; TCP, trichlorophenol ; TCS, triclosan; TG, triglyceride; TNC, transnonachlordane; VAT, visceral adipose tissue; W, weight; WC, waist circumference.