Studies focusing on dietary pesticides in population-based samples are scarce and little is known about potential mixture effects. We aimed to assess associations between dietary pesticide exposure profiles and Type 2 Diabetes (T2D) among NutriNet-Santé cohort participants. Participants completed a Food Frequency Questionnaire at baseline, assessing conventional and organic food consumption. Exposures to 25 active substances used in European Union pesticides were estimated using the Chemisches und Veterinäruntersuchungsamt Stuttgart residue database accounting for farming practices. T2D were identified through several sources. Exposure profiles were established using Non-Negative Matrix Factorization (NMF), adapted for sparse data. Cox models adjusted for known confounders were used to estimate hazard ratios (HR) and 95% confidence interval (95% CI), for the associations between four NMF components, divided into quintiles (Q) and T2D risk. The sample comprised 33,013 participants aged 53 years old on average, including 76% of women. During follow-up (median: 5.95 years), 340 incident T2D cases were diagnosed. Positive associations were detected between NMF component 1 (reflecting highest exposure to several synthetic pesticides) and T2D risk on the whole sample: HRQ5vsQ1 = 1.47, 95% CI (1.00, 2.18). NMF Component 3 (reflecting low exposure to several synthetic pesticides) was associated with a decrease in T2D risk, among those with high dietary quality only (high adherence to French dietary guidelines, including high plant foods consumption): HRQ5vsQ1 = 0.31, 95% CI (0.10, 0.94). These findings suggest a role of dietary pesticide exposure in T2D risk, with different effects depending on which types of pesticide mixture participants are exposed to. These associations need to be confirmed in other types of studies and settings, and could have important implications for developing prevention strategies (regulation, dietary guidelines). This study is registered in ClinicalTrials.gov ( NCT03335644 ).

中文翻译：

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NutriNet-Santé 队列中膳食农药暴露与 2 型糖尿病风险之间的前瞻性关联

关注人群样本中膳食农药的研究很少，而且对潜在的混合效应知之甚少。我们旨在评估 NutriNet-Santé 队列参与者的膳食农药暴露概况与 2 型糖尿病 (T2D) 之间的关联。参与者在基线时完成了一份食物频率问卷，评估传统和有机食物的消费。使用Chemisches und Veterinäruntersuchungsamt Stuttgart 农业实践残留数据库估算了欧盟农药中使用的 25 种活性物质的暴露量。T2D 是通过多个来源确定的。使用适用于稀疏数据的非负矩阵分解 (NMF) 建立曝光曲线。针对已知混杂因素调整的 Cox 模型用于估计风险比 (HR) 和 95% 置信区间 (95% CI)，用于四个 NMF 成分之间的关​​联，分为五分位数 (Q) 和 T2D 风险。该样本包括 33,013 名平均年龄为 53 岁的参与者，其中 76% 为女性。在随访期间（中位数：5.95 年），诊断出 340 例 T2D 病例。在整个样本中检测到 NMF 成分 1（反映对几种合成农药的最高暴露量）与 T2D 风险之间存在正相关：HRQ5vsQ1 = 1.47, 95% CI (1.00, 2.18)。NMF 成分 3（反映对几种合成农药的低接触）与 T2D 风险降低有关，仅在那些饮食质量高的人群中（高度遵守法国饮食指南，包括高植物性食物消费）：HRQ5vsQ1 = 0.31, 95% CI (0.10, 0.94)。这些研究结果表明，膳食农药暴露在 T2D 风险中的作用，其影响取决于参与者接触的农药混合物类型。这些关联需要在其他类型的研究和环境中得到证实，并且可能对制定预防策略（监管、饮食指南）产生重要影响。该研究已在 ClinicalTrials.gov (NCT03335644) 上注册。