Arsenic Exposure and Incidence of Type 2 Diabetes in Southwestern American Indians

Abstract

Association of urinary arsenic concentration with incident diabetes was examined in American Indians from Arizona who have a high prevalence of type 2 diabetes and were screened for diabetes between 1982 and 2007. The population resides where drinking water contains arsenic at concentrations above federally recommended limits. A total of 150 nondiabetic subjects aged ≥25 years who subsequently developed type 2 diabetes were matched by year of examination and sex to 150 controls who remained nondiabetic for ≥10 years. Total urinary arsenic concentration, adjusted for urinary creatinine level, ranged from 6.6 µg/L to 123.1 µg/L, and inorganic arsenic concentration ranged from 0.1 µg/L to 36.0 µg/L. In logistic regression models adjusted for age, sex, body mass index, and urinary creatinine level, the odds ratios for incident diabetes were 1.11 (95% confidence interval (CI): 0.79, 1.57) and 1.16 (95% CI: 0.89, 1.53) for a 2-fold increase in total arsenic and inorganic arsenic, respectively. Categorical analyses suggested a positive relationship between quartiles of inorganic arsenic and incident diabetes (P = 0.056); post-hoc comparison of quartiles 2-4 with quartile 1 revealed 2-fold higher odds of diabetes in the upper quartiles (OR = 2.14, 95% CI: 1.19, 3.85). Modestly elevated exposure to inorganic arsenic may predict type 2 diabetes in American Indians. Larger studies that include measures of speciated arsenic are required for confirmation.

Chronic Arsenic Toxicity from Drinking Well Water in a Rural Area

“…However, prevalence of essential hypertension and diabetes were higher among individuals with positive urine test when compared to others, though the differences were statistically insignificant. The mean duration of residence was 52.6 17.4 yr in the present study which is much higher than similar studies [14][15][16][17][18][19].…”

“…Another study has suggested 2.5-fold higher prevalence of diabetes in arsenic exposure [16]. Some studies also suggested the relationship 35 http://www.ijt.ir; Volume 11, No 6, November-December2017 between arsenic exposure and prevalence of diabetes [13,19]. The relationship also has suggested in studies conducted in industrial exposure of arsenic [20][21][22].…”

A case of secondary diabetes mellitus associated with chronic arsenic toxicity

“…Historically, the evidence describing the association with arsenic exposure and prevalence of diabetes came from community-based studies in Taiwan and Bangladesh, where people were exposed to drinking water contaminated with arsenic. [1][2][3][4] More recently, evidence from the United States, Mexico and Canada have supported this association, [5][6][7][8][9] and a recent meta-analysis found that every 100 mcg/L increment of iAs in drinking water was associated with a 13% increase in the incidence of diabetes. [18] Additionally, there is emerging evidence that arsenic metabolism, as opposed to iAs exposure alone, may play a role in the diabetogenic effects of arsenic.…”

“…While the majority of the literature surrounding arsenic-induced DM has involved areas in Taiwan and Bangladesh where the arsenic content of drinking water is high, [1][2][3][4] there have been several other population-based studies in North America that have shown a similar association. [5][6][7][8][9] Here, we present a case of newlydiagnosed DM that was thought to be secondary to chronic arsenic exposure.…”

Exposition à l'arsenic et diabète de type 2 : résultats de l’Enquête canadienne sur les mesures de la santé de 2007 à 2009

“…Une recension systématique des études épidémiologiques sur l'exposition à l'arsenic et le DT2 a indiqué que la majorité de ces études employaient des méthodes dites écologiques pour évaluer l'exposition et qu'elles n'ont pas été ajustées pour les facteurs de confusion potentiels 14 . Certaines études ayant utilisé la concentration urinaire d'arsenic comme biomarqueur de l'exposition n'ont pas décelé d'association entre l'exposition à l'arsenic et le diabète 19,20 , alors que d'autres ont signalé une relation dose-réponse [21][22][23][24][25][26][27] . Par ailleurs, aucune étude n'a évalué cette association dans la population canadienne.…”