Arsenic Exposure, Diabetes Prevalence, and Diabetes Control in the Strong Heart Study
Arsenic Exposure, Diabetes Prevalence, and Diabetes Control in the Strong Heart Study
复制标题
DOI：
10.1093/aje/kws153
复制
发表时间：
2012-11-15
影响因子：
5
通讯作者：
Navas-Acien, Ana
中科院分区：
文献类型：
--
作者：
Gribble, Matthew O.;Howard, Barbara V.;Navas-Acien, Ana
本研究评估了砷暴露与糖尿病患病率、糖化血红蛋白和胰岛素抵抗在亚利桑那州、俄克拉何马州、北达科他州和南达科他州的美国印第安成年人中的关系（1989 - 1991）。我们研究了3925名男性和女性，年龄4574岁，有可用的尿砷测量方法。糖尿病被定义为空腹血糖水平为126 mg/dL或更高，2小时血糖水平为200 mg/dL或更高，血红蛋白A1c （HbA1c）为6.5或更高，或糖尿病治疗。尿砷浓度中位数为14.1 g/L（四分位数差为7.924.2）。糖尿病患病率为49.4。在对社会人口因素、糖尿病危险因素和尿肌酐进行调整后，总砷浓度的第75百分位数与第25百分位数比较，糖尿病患病率为1.14（95可信区间：1.08,1.21）。砷与糖尿病之间的关联仅限于糖尿病控制不良的参与者（糖化血红蛋白epsilon 8）。砷与糖尿病患者的糖化血红蛋白水平呈正相关。在没有糖尿病的参与者中，砷与HbA1c或胰岛素抵抗（通过稳态模型评估来量化胰岛素抵抗）无关。尿砷与美国农村糖尿病高负担人群的糖尿病控制有关。需要前瞻性研究来评估糖尿病控制不良与砷暴露之间的关系。
This study evaluated the association of arsenic exposure, as measured in urine, with diabetes prevalence, glycated hemoglobin, and insulin resistance in American Indian adults from Arizona, Oklahoma, and North and South Dakota (19891991). We studied 3,925 men and women 4574 years of age with available urine arsenic measures. Diabetes was defined as a fasting glucose level of 126 mg/dL or higher, a 2-hour glucose level of 200 mg/dL or higher, a hemoglobin A1c (HbA1c) of 6.5 or higher, or diabetes treatment. Median urine arsenic concentration was 14.1 g/L (interquartile range, 7.924.2). Diabetes prevalence was 49.4. After adjustment for sociodemographic factors, diabetes risk factors, and urine creatinine, the prevalence ratio of diabetes comparing the 75th versus 25th percentiles of total arsenic concentrations was 1.14 (95 confidence interval: 1.08, 1.21). The association between arsenic and diabetes was restricted to participants with poor diabetes control (HbA1c epsilon 8). Arsenic was positively associated with HbA1c levels in participants with diabetes. Arsenic was not associated with HbA1c or with insulin resistance (assessed by homeostatic model assessment to quantify insulin resistance) in participants without diabetes. Urine arsenic was associated with diabetes control in a population from rural communities in the United States with a high burden of diabetes. Prospective studies that evaluate the direction of the relation between poor diabetes control and arsenic exposure are needed.