The association between p,p'-DDE levels and left ventricular mass is mainly mediated by obesity

Environ Res. 2018 Jan:160:541-546. doi: 10.1016/j.envres.2017.10.031. Epub 2017 Oct 26.


Background and objectives: The pesticide metabolite p,p'-DDE has been associated with left ventricular (LV) mass and known risk factors for LV hypertrophy in humans and in experimental models. We hypothesized that the associations of p,p'-DDE with LV hypertrophy risk factors, namely elevated glucose, adiposity and hypertension, mediate the association of p,p'-DDE with LV mass.

Methods: p,p'-DDE was measured in plasma from 70-year-old subjects (n = 988) of the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS). When these subjects were 70-, 75- and 80- years old, LV characteristics were measured by echocardiography, while fasting glucose, body mass index (BMI) and blood pressure were assessed with standard clinical techniques.

Results: We found that p,p'-DDE levels were associated with increased fasting glucose, BMI, hypertension and LV mass in separate models adjusted for sex. Structural equation modeling revealed that the association between p,p'-DDE and LV mass was almost entirely mediated by BMI (70%), and also by hypertension (19%).

Conclusion: The obesogenic effect of p,p'-DDE is a major determinant responsible for the association of p,p'-DDE with LV mass.

Keywords: Glucose; Hypertension; Left ventricular hypertrophy; Obesity; P,p′-DDE.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity / physiology
  • Aged
  • Aged, 80 and over
  • Blood Glucose / analysis
  • Cohort Studies
  • Dichlorodiphenyl Dichloroethylene / toxicity*
  • Environmental Pollutants / toxicity*
  • Female
  • Heart Ventricles / physiopathology*
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology
  • Hypertrophy, Left Ventricular / chemically induced
  • Hypertrophy, Left Ventricular / epidemiology*
  • Insecticides / toxicity*
  • Male
  • Obesity / chemically induced
  • Obesity / epidemiology*
  • Prevalence
  • Risk Factors
  • Sweden / epidemiology


  • Blood Glucose
  • Environmental Pollutants
  • Insecticides
  • Dichlorodiphenyl Dichloroethylene