Arsenic Exposure and Incidence of Type 2 Diabetes in Southwestern American Indians
Arsenic Exposure and Incidence of Type 2 Diabetes in Southwestern American Indians
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DOI：
10.1093/aje/kws329
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发表时间：
2013-05-01
影响因子：
5
通讯作者：
Sandler, Dale P.
中科院分区：
文献类型：
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作者：
Kim, Nan Hee;Mason, Clinton C.;Sandler, Dale P.
在1982年至2007年期间，对来自亚利桑那州的2型糖尿病高患病率的美国印第安人进行了糖尿病筛查，研究了尿砷浓度与糖尿病发病率之间的关系。居住在饮用水中砷含量超过联邦建议限制的人口。150名年龄为>= 25岁的非糖尿病受试者随后发展为2型糖尿病，按检查年份和性别与150名年龄为>= 10年的非糖尿病受试者相匹配。根据尿肌酐水平调整后的尿总砷浓度在6.6 ~ 123.1 μ g/L之间，无机砷浓度在0.1 ~ 36.0 μ g/L之间。在调整了年龄、性别、体重指数和尿肌酐水平的logistic回归模型中，总砷和无机砷增加2倍时，发生糖尿病的比值比分别为1.11（95%可信区间（CI）： 0.79, 1.57）和1.16 （95% CI: 0.89, 1.53）。分类分析表明，无机砷四分位数与糖尿病发病率呈正相关（P = 0.056）；四分位数2-4与四分位数1的事后比较显示，上四分位数患糖尿病的几率高出2倍（OR = 2.14, 95% CI: 1.19, 3.85）。适度升高的无机砷暴露可以预测美国印第安人的2型糖尿病。需要进行更大规模的研究，包括特定砷的测量才能得到证实。
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 mu g/L to 123.1 mu g/L, and inorganic arsenic concentration ranged from 0.1 mu g/L to 36.0 mu g/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.