***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Low doses of some persistent organic pollutants ( POPs ) associate cross-sectionally with  type 2 diabetes  , whereas associations with high POP exposures are inconsistent . Objectives We investigated whether several POPs prospect ively predict type 2 diabetes  within the Coronary Artery Risk Development in Young Adults ( CARDIA ) cohort . Methods Participants in this nested case – control study were diabetes free in 1987–1988 . By 2005–2006 , the 90 controls remained free of diabetes , whereas the 90 cases developed diabetes . Using serum collected in 1987–1988 , we measured 8 organochlorine pesticides , 22 polychlorinated biphenyl congeners ( PCBs ) , and 1 polybrominated biphenyl ( PBB ) . We compared POP concentrations from CARDIA and the National Health and Nutrition Examination Survey ( NHANES ) in 2003–2004 . We computed odds ratios ( ORs ) for incident diabetes using logistic regression analysis . Results Chlorinated POPs in CARDIA in 1987–1988 were much higher than corresponding NHANES 2003 - 2004 concentrations . POPs showed nonlinear associations with diabetes risk . The highest risk was observed in the second quartiles of trans-nonachlor , oxychlordane , mirex , highly chlorinated PCBs , and PBB153—a finding that suggests low-dose effects . We concentrated risk by summing these POPs and isolated very low concentrations of multiple POPs in the lowest sextile of the sum . The adjusted OR in the second sextile vs. the lowest sextile was 5.3 overall and 20.1 for body mass index ≥ 30 kg/m2 . Conclusions Several POPs at low doses similar to current exposure levels may increase diabetes risk , possibly through endocrine disruption . Certain POPs may a play a role in the current epidemic of diabetes , which has been attributed to obesity Background Studies have demonstrated ubiquitous human exposure to persistent organic pollutants ( POPs ) such as p , p′-diphenyldichloroethene ( DDE ) and polychlorinated biphenyls ( PCBs ) . Although there is considerable evidence that POP exposures are associated with prevalent diabetes , these studies do not establish causality because the cross-sectional study design does not allow for assessment of temporality of the exposure – disease association . Prospect i ve studies , however , have been lacking . Objectives This study was design ed to determine whether POP body burdens are related to incidence of diabetes in a cohort of Great Lakes sport fish consumers . Methods The cohort was established in the early 1990s and followed through 2005 . We tested serum for DDE and PCB congeners and assessed diabetes diagnosis , demographics , and fish consumption . Associations of diabetes with exposures were examined prospect ively in participants without diabetes in 1994–1995 , followed through 2005 . Annual percent changes in DDE and PCB-132/153 from 1994 to 2005 were examined by diabetes status . Results DDE exposure was associated with incident diabetes . Incident diabetes was not associated with mono-ortho PCB-118 , total PCBs , or years of sport fish consumption . Annual percent change in DDE and PCB-132/153 did not differ significantly by diabetes status . Conclusions This study demonstrates an association between DDE exposure and incident diabetes . The findings of an association of DDE with incident diabetes and the lack of effect of diabetes on annual percent change in POPs do not support the hypothesis that associations of POPs with diabetes are attributable to reverse causality . Additional studies should address the biological pathways by which DDE could affect glucose homeostasis PURPOSE Emerging evidence suggests that exposure to endocrine disruptors may initiate or exacerbate adiposity and associated health problems . This study examined sex differences in the association of urinary level of bisphenol-A ( BPA ) with selected indices of glucose homeostasis among U.S. adults . METHODS Data analyses were performed using a sample of 1586 participants from the 2005 to 2008 National Health and Nutrition Examination Surveys . BPA level and the ratio of BPA-to-creatinine level were defined as log-transformed variables and in quartiles . Selected indices of glucose homeostasis were defined using fasting glucose and insulin data . Multivariate linear and logistic regression models for the hypothesized relationships were constructed after controlling for age , sex , race , education , marital status , smoking status , physical activity , total dietary intake , and urinary creatinine concentration . RESULTS Taking the first quartile as a referent , the third quartile of BPA level was positively associated with log-transformed level of insulin and β-cell function ( homeostasis model assessment for β-cell function ) as well as insulin resistance ( log-transformed homeostasis model assessment for insulin resistance ; homeostasis model assessment for insulin resistance ≥2.5 ) , with significant BPA-by-sex interaction ; these associations were stronger among males than among females . Irrespective of sex , the ratio of BPA-to-creatinine level was not predictive of indices of glucose homeostasis . CONCLUSIONS A complex association may exist between BPA and hyperinsulinemia  among adult U.S. men . Prospect i ve cohort studies are needed to further eluci date endocrine disruptors as determinants of adiposity-related disturbances Background : Polychlorinated biphenyls ( PCBs ) manufactured in Anniston , Alabama , from 1929 to 1971 caused significant environmental contamination . The Anniston population remains one of the most highly exposed in the world . Objectives : Reports of increased diabetes in PCB-exposed population s led us to examine possible associations in Anniston residents . Methods : Volunteers ( n = 774 ) from a cross-sectional study of r and omly selected households and adults who completed the Anniston Community Health Survey also underwent measurements of height , weight , fasting glucose , lipid , and PCB congener levels and verification of medications .  Odds ratios ( ORs ) and 95 % confidence intervals ( CIs ) were calculated to assess the relationships between PCBs and diabetes , adjusting for diabetes risk factors . Participants with prediabetes were excluded from the logistic regression analyses . Results : Participants were 47 % African American , 70 % female , with a mean age of 54.8 years . The prevalence of diabetes was 27 % in the study population , corresponding to an estimated prevalence of 16 % for Anniston overall ; the PCB body burden of 35 major congeners ranged from 0.11 to 170.42 ppb , wet weight . The adjusted OR comparing the prevalence of diabetes in the fifth versus first quintile of serum PCB was 2.78 ( 95 % CI : 1.00 , 7.73 ) , with similar associations estimated for second through fourth quintiles . In participants < 55 years of age , the adjusted OR for diabetes for the highest versus lowest quintile was 4.78 ( 95 % CI : 1.11 , 20.6 ) , whereas in those ≥ 55 years of age , we observed no significant associations with PCBs . Elevated diabetes prevalence was observed with a 1 SD increase in log PCB levels in women ( OR = 1.52 ; 95 % CI : 1.01 , 2.28 ) ; a decreased prevalence was observed in men ( OR = 0.68 ; 95 % CI : 0.33 , 1.41 ) . Conclusions : We observed significant associations between elevated PCB levels and diabetes mostly due to associations in women and in individuals < 55 years of age Low-dose organochlorine ( OC ) pesticides have recently been associated with  type 2 diabetes in several non-Asian general population s. As there is currently epidemic type 2 diabetes in Asia , we investigated the associations between  OC pesticides and type 2 diabetes in Koreans . Among subjects who participated in a community-based health survey , we r and omly selected 40 diabetic patients and 40 normal controls . Ten OC pesticides ( beta-hexachlorocyclohexane , hexachlorobenzene , heptachlor epoxide , p , p'-DDE , p , p'-DDD , p , p'-DDT , o , p'-DDT , oxychlordane , trans-nonachlor , and mirex ) detectable in > or=70 % of controls were analyzed in relation to diabetes . Most OC pesticides showed strong associations with type 2 diabetes after adjusting for age , sex , BMI , alcohol consumption , and cigarette smoking . Compared with subjects in the lowest tertile of each OC pesticide , adjusted odds ratios ( ORs ) in the 3rd tertile ranged from 3.1 ( 95 % CI 0.8 - 12.1 ) for heptachlor epoxide to 26.0 ( 95 % CI 1.3 - 517.4 ) for oxychlordane . In the case of chemicals belonging to the DDT family , adjusted ORs in the 3rd tertile were in the range of 10.6 ( 95 % CI 1.3 - 84.9 ) for p , p'-DDT to 12.7 ( 95 % CI 1.9 - 83.7 ) for p , p'-DDE . In this exploratory study with small sample , low-dose background exposure to OC pesticides was strongly associated with prevalent  type 2 diabetes in Koreans even though absolute concentrations of OC pesticides were no higher than in other population s. Asians may be more susceptible to adverse effects of OC pesticides than other races Recent in vitro and animal studies have reported estrogen-like activity of chemicals used in sunscreen preparations . We investigated whether the three sunscreens benzophenone-3 ( BP-3 ) , octyl-methoxycinnamate ( OMC ) , and 3-(4-methylbenzylidene ) camphor ( 4-MBC ) were absorbed and influenced endogenous reproductive hormone levels in humans after topical application . In this 2-wk single-blinded study 32 healthy volunteers , 15 young males and 17 postmenopausal females , were assigned to daily whole-body topical application of 2 mg per cm(2 ) of basic cream formulation without ( week 1 ) and with ( week 2 ) the three sunscreens at 10 % ( wt/wt ) of each . Maximum plasma concentrations were 200 ng per mL BP-3 , 20 ng per mL 4-MBC , and 10 ng per mL OMC for females and 300 ng per mL BP-3 , 20 ng per mL 4-MBC , and 20 ng per mL OMC for men . All three sunscreens were detectable in urine . The reproductive hormones FSH , LH were unchanged but minor differences in testosterone levels were observed between the 2 wk . A minor difference in serum estradiol and inhibin B levels were observed in men only . These differences in hormone levels were not related to sunscreen exposure Aims /hypothesis Prospect i ve data directly investigating the role of endogenous sex hormones in diabetes risk have been scant , particularly in women . We aim ed to examine comprehensively plasma sex hormones in connection with risk of developing type 2 diabetes  in postmenopausal women . Methods We conducted a prospect i ve , nested case – control study of  plasma oestradiol , testosterone and dehydroepi and rosterone sulfate  and risk of type 2 diabetes in a cohort of women health professionals with a mean age of 60.3 and 12.2 years since menopause . Among women not using hormone therapy and free of baseline cardiovascular disease , cancer and diabetes , 359 incident cases of type 2 diabetes were matched with 359 controls during an average follow-up of 10 years . Results Oestradiol and testosterone were each strongly and positively associated with risk of type 2 diabetes . After adjustment for BMI , family history , lifestyle and reproductive variables , the multivariable relative risks ( 95 % CI ) comparing the highest vs lowest quintile were 12.6 ( 2.83–56.3 ) for total oestradiol ( p = 0.002 for trend ) , 13.1 ( 4.18–40.8 ) for free oestradiol ( p < 0.001 for trend ) , 4.15 ( 1.21–14.2 ) for total testosterone ( p = 0.019 for trend ) and 14.8 ( 4.44–49.2 ) for free testosterone ( p < 0.001 for trend ) . These associations remained robust after adjusting and accounting for other metabolic syndrome components and baseline HbA1c levels . Conclusions /interpretationIn postmenopausal women , higher plasma levels of oestradiol and testosterone were strongly and prospect ively related to increased risk of developing type 2 diabetes . These prospect i ve data indicate that endogenous levels of sex hormones may play important roles in the pathogenesis of type 2 diabetes . Clinical Trials.gov ID no. : NCT00000479 BACKGROUND Bisphenol A ( BPA ) is 
    Output:
    
Persistent and non-persistent EDCs may affect the risk of T2D .