A case-cohort study examining lifetime exposure to inorganic arsenic in drinking water and diabetes mellitus
A case-cohort study examining lifetime exposure to inorganic arsenic in drinking water and diabetes mellitus
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DOI：
10.1016/j.envres.2013.02.005
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发表时间：
2013-05-01
影响因子：
8.3
通讯作者：
Byers, Tim E.
中科院分区：
文献类型：
--
作者：
James, Katherine A.;Marshall, Julie A.;Byers, Tim E.
背景资料：饮用无机砷含量高（超过500 μ g/L）的饮用水与II型糖尿病（DM）有关，但以前的研究对较低水平（< 100 μ g/L）的风险没有定论。我们提出了一个病例队列研究的基础上个人估计的一生砷暴露，以探讨慢性低水平砷暴露和DM的风险之间的关系。方法：这个病例队列研究包括141例糖尿病诊断1984年和1998年之间的前瞻性圣路易斯谷糖尿病研究的一部分。从936名基线时无疾病的合格参与者中随机抽取了488名参与者的比较子队列。个人一生砷暴露估计确定使用的方法，包括使用结构化访谈，以确定一生的居住和就业史，地理空间模型的饮用水中的砷浓度，尿砷浓度。采用考克斯比例风险模型，以已知的糖尿病风险因素作为时间依赖性协变量，评估饮用水中无机砷终生暴露与糖尿病发病之间的关系。我们的研究结果显示无机砷暴露与糖尿病风险之间存在显著相关性（风险比[HR]=1.27，95%=1.01，1.59/15 μ g/L），同时调整种族和随时间变化的协变量年龄、体重指数和体力活动水平。根据一项全面的终生暴露评估，饮用水中低水平无机砷暴露与该人群II型糖尿病风险增加相关。(C)2013 Elsevier Inc. All rights reserved.
Background: Consumption of drinking water with high levels of inorganic arsenic (over 500 mu g/L) has been associated with type II diabetes mellitus (DM), but previous studies have been inconclusive about risks at lower levels (< 100 mu g/L). We present a case-cohort study based on individual estimates of lifetime arsenic exposure to examine the relationship between chronic low-level arsenic exposure and risk of DM.Methods: This case-cohort study included 141 cases of DM diagnosed between 1984 and 1998 as part of the prospective San Luis Valley Diabetes Study. A comparison sub-cohort of 488 participants was randomly sampled from 936 eligible participants who were disease free at baseline. Individual lifetime arsenic exposure estimates were determined using a methodology that incorporates the use of a structured interview to determine lifetime residence and employment history, geospatial modeling of arsenic concentrations in drinking water, and urine arsenic concentrations. A Cox proportional hazards model with known DM risk factors as time-dependent covariates was used to assess the association between lifetime exposure to inorganic arsenic in drinking water and incident DM.Results: Our findings show a significant association between inorganic arsenic exposure and DM risk (hazard ratio [HR]=1.27, 95%=1.01, 1.59 per 15 mu g/L) while adjusting for ethnicity and time varying covariates age, body mass index and physical activity level.Conclusions: Exposure to low-level inorganic arsenic in drinking water is associated with increased risk for type II DM in this population based on a comprehensive lifetime exposure assessment. (C) 2013 Elsevier Inc. All rights reserved.