Biological Gradient Between Long-Term Arsenic Exposure and Carotid Atherosclerosis

Abstract

Background-Long-term exposure to ingested arsenic has been documented to induce peripheral vascular disease, ischemic heart disease, and cerebral infarction in a dose-response relationship. This study further examined the biological gradient between ingested inorganic arsenic and carotid atherosclerosis. Methods and Results-We studied 199 male and 264 female adult residents from the southwestern area of endemic arseniasis in Taiwan. The extent of carotid atherosclerosis was assessed by duplex ultrasonography. Diabetes mellitus was determined by oral glucose tolerance test, hypertension by mercury sphygmomanometers, and serum lipid profiles by autoanalyzers. Information regarding the consumption of high-arsenic artesian well water, cigarette smoking, and alcohol consumption was obtained through standardized questionnaire interviews. Logistic regression analysis was used to estimate the odds ratio and its 95% CI of carotid atherosclerosis for various risk factors. Three indices of long-term exposure to ingested arsenic, including the duration of consuming artesian well water, the average arsenic concentration in consumed artesian well water, and cumulative arsenic exposure, were all significantly associated with prevalence of carotid atherosclerosis in a dose-response relationship. The biological gradient remained significant after adjustment for age, sex, hypertension, diabetes mellitus, cigarette smoking, alcohol consumption, waist-to-hip ratio, and serum levels of total cholesterol and LDL cholesterol. The multivariate-adjusted odds ratio was 3.1 (95% CI 1.3 to 7.4) for those who had a cumulative arsenic exposure of Ն20 mg/L-years compared with those without exposure to arsenic from drinking artesian well water. Conclusions-Carotid atherosclerosis is associated with ingested inorganic arsenic, showing a significant biological

Prevalence of non-insulin-dependent diabetes mellitus and related vascular diseases in southwestern arseniasis-endemic and nonendemic areas in Taiwan.

“…The finding of a strikingly increased prevalence of macrovascular diseases observed in the arseniasis-endemic area compared with the nonendemic area is consistent with our previous findings of arsenic-induced atherosclerosis (Chen et al 1988bChiou et al 1997b;Tseng et al 1996;Wang et al 2002;Wu et al 1989). There have been few studies comparing the prevalence of specific vascular diseases in relation to arsenic exposure in diabetics and nondiabetics.…”

“…Diabetes was associated with an increased risk of cerebrovascular disease showing an age-and gender-adjusted odds ratio of 1.8 in the northeastern endemic area and 2.4 (21.35 ÷ 8.72) in the southwestern endemic area of this study. A previous study showed a dose-response relationship between ingested arsenic and peripheral vascular diseases (Wang et al 2002). The present study demonstrated the odds ratios of 1.2 (95% CI, 1.1-1.4) in diabetics and 12.5 (95% CI, 9.5-16.5) in nondiabetics.…”

“…Other chronic health effects induced by arsenic have also drawn global attention, especially cardiovascular, neurologic, reproductive, and developmental hazards (Chen et al 1997a(Chen et al , 1999. Mortality and morbidity of vascular diseases, including peripheral vascular disease, cerebral infarction, and ischemic heart disease, have been documented to be associated with arsenic levels in drinking water in the arseniasisendemic area (Chen et al 1988bChiou et al 1997b;Tseng et al 1996;Wang et al 2002;Wu et al 1989). The associations between long-term exposure to arsenic and microvascular diseases, including renal disease, retinopathy, and neuropathy, remain to be elucidated.…”

Cardiovascular effects of arsenic: clinical and epidemiological findings

“…Consistent with the association with risk factors and CV disease, an association has also been found between As exposure and atherosclerosis (Wang et al 2002;Wang et al 2010;Hsieh et al 2011), and confirmed in experimental animal studies (Bunderson et al 2004;Srivastava et al 2009;Lemaire et al 2011). …”

Activation of protein kinase C and disruption of endothelial monolayer integrity by sodium arsenite—Potential mechanism in the development of atherosclerosis

“…Epidemiological studies analyzing the correlation between cardiovascular diseases and arsenic exposure, have linked arsenic to atherosclerosis (Wang et al, 2002), ischemic heart disease (Tseng et al, 2003) and hypertension (Rahman et al, 1999). Drinking water is a significant source of arsenic exposure to humans.…”