Low-level Population Exposure to Inorganic Arsenic in the United States and Diabetes Mellitus
- 1 November 2009
- journal article
- toxic metals
- Published by Ovid Technologies (Wolters Kluwer Health) in Epidemiology
- Vol. 20 (6), 807-815
- https://doi.org/10.1097/ede.0b013e3181b0fd29
Abstract
Background: Although studies have reported associations between high concentrations of ingested inorganic arsenic and diabetes mellitus, there is no evidence of this association at low exposures. However, a well-publicized study (JAMA. 2008;300:814–822) recently produced an extraordinary finding of a more than 3-fold increase in diabetes at low concentrations of urinary arsenic. This potentially affects 40 million adults in the United States. Methods: We used the same cross-sectional data on urinary arsenic and type 2 diabetes mellitus in 795 adults from the 2003–2004 National Health and Nutrition Examination Survey to assess this evidence. Results: As in the earlier study, we found an odds ratio (OR) near 1.0 for diabetes, comparing the 80th versus 20th percentiles of urinary total arsenic (OR = 0.88 [95% confidence interval = 0.39–1.97]). This OR increased to above 3.0 when urinary arsenobetaine was added to the logistic risk model. However, this high OR was a statistical artifact because arsenobetaine, which is ingested from fish and is essentially nontoxic, is a part of measured total urinary arsenic. These 2 variables are highly correlated (correlation = 0.80). Because arsenobetaine is a part of total arsenic, it should first be subtracted from total arsenic rather than being added to the statistical model. Doing so yields an OR of 1.15 (0.53–2.50). Conclusion: These findings show no evidence of increased risk of diabetes with arsenic exposure in this dataset. This underscores the importance of valid statistical techniques and careful consideration of scientific plausibility when investigating low-concentration chemical exposures.Keywords
This publication has 25 references indexed in Scilit:
- Arsenic Exposure and Prevalence of Type 2 Diabetes in US AdultsJAMA, 2008
- Levels of urinary total and speciated arsenic in the US population: National Health and Nutrition Examination Survey 2003–2004Journal of Exposure Science & Environmental Epidemiology, 2008
- Arsenic and diabetes and hypertension in human populations: A reviewToxicology and Applied Pharmacology, 2007
- Collinearity in linear regression is a serious problem in oral health researchEuropean Journal of Oral Sciences, 2004
- Arsenic speciation in human urine: are we all the same?Toxicology and Applied Pharmacology, 2004
- Variability in human metabolism of arsenicEnvironmental Research, 2003
- The role of biomethylation in toxicity and carcinogenicity of arsenic: a research update.Environmental Health Perspectives, 2002
- Worldwide Occurrences of Arsenic in Ground WaterScience, 2002
- Arsenic in seafoods: Human health aspects and regulationsMarine Pollution Bulletin, 1993
- Arsenic speciation in the environmentChemical Reviews, 1989