Relationship between Exposure to PAH's and Insulin Resistance

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1. Introduction
Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous environmental toxic compounds with fused aromatic rings, formed from incomplete combustion of carbon-containing materials such as coal and fossil fuels, cigarette smoking, and food cooking.1,2 Non-occupational exposure routes of PAHs include: inhalation airborne PAHs such as polluted air or cigarette smoking, ingestion of PAH-containing food such as charred and broiled meat, as well as dermal absorption.3,4 PAHs can bioaccumulate through the food chain because of its nature of resistant to degradation.5 The adverse health effects of PAHs have been widely studied recently mainly focusing on increasing risks of chronic diseases such as cardiovascular diseases (CVD) and a variety of cancers, including respiratory, renal, and breast cancers.6-15 Recently, several studies suggested an association between ambient air pollution and type 2 diabetes (T2DM), and ambient fine particulate matter (PM) may induce insulin resistance.16-21 Since air pollution as well as smoking and red meat consumption were consistently linked to cardiometabolic diseases such as diabetes,22,23 and all of them are important exposure sources of PAHs, it’s biologically plausible that PAHs may play important roles in the relationship between cigarette smoking, ambient air pollution and cardiometabolic diseases.
Insulin resistance is a state where there is reduced biological effect for any given concentration of insulin.24,25 It is regarded

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