Association of Low-Moderate Arsenic Exposure and Arsenic Metabolism with Incident Diabetes and Insulin Resistance in the Strong Heart Family Study
High arsenic exposure has been related to diabetes, but at low-moderate levels the evidence is mixed. Arsenic metabolism, which is partly genetically controlled and may rely on certain B vitamins, plays a role in arsenic toxicity. We evaluated the prospective association of arsenic exposure and meta...
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| Veröffentlicht in: | Environmental health perspectives 2017-12, Vol.125 (12), p.127004 |
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| creator | Grau-Perez, Maria Kuo, Chin-Chi Gribble, Matthew O Balakrishnan, Poojitha Jones Spratlen, Miranda Vaidya, Dhananjay Francesconi, Kevin A Goessler, Walter Guallar, Eliseo Silbergeld, Ellen K Umans, Jason G Best, Lyle G Lee, Elisa T Howard, Barbara V Cole, Shelley A Navas-Acien, Ana |
| description | High arsenic exposure has been related to diabetes, but at low-moderate levels the evidence is mixed. Arsenic metabolism, which is partly genetically controlled and may rely on certain B vitamins, plays a role in arsenic toxicity.
We evaluated the prospective association of arsenic exposure and metabolism with type 2 diabetes and insulin resistance.
We included 1,838 American Indian men and women free of diabetes (median age, 36 y). Arsenic exposure was assessed as the sum of inorganic arsenic (iAs), monomethylarsonate (MMA), and dimethylarsinate (DMA) urine concentrations (ΣAs). Arsenic metabolism was evaluated by the proportions of iAs, MMA, and DMA over their sum (iAs%, MMA%, and DMA%). Homeostasis model assessment for insulin resistance (HOMA2-IR) was measured at baseline and follow-up visits. Incident diabetes was evaluated at follow-up.
Median ΣAs, iAs%, MMA%, and DMA% was 4.4 μg/g creatinine, 9.5%, 14.4%, and 75.6%, respectively. Over 10,327 person-years of follow-up, 252 participants developed diabetes. Median HOMA2-IR at baseline was 1.5. The fully adjusted hazard ratio [95% confidence interval (CI)] for incident diabetes per an interquartile range increase in ΣAs was 1.57 (95% CI: 1.18, 2.08) in participants without prediabetes at baseline. Arsenic metabolism was not associated with incident diabetes. ΣAs was positively associated with HOMA2-IR at baseline but negatively with HOMA2-IR at follow-up. Increased MMA% was associated with lower HOMA2-IR when either iAs% or DMA% decreased. The association of arsenic metabolism with HOMA2-IR differed by B-vitamin intake and
genetics variants.
Among participants without baseline prediabetes, arsenic exposure was associated with incident diabetes. Low MMA% was cross-sectional and prospectively associated with higher HOMA2-IR. Research is needed to confirm possible interactions of arsenic metabolism with B vitamins and
variants on diabetes risk. https://doi.org/10.1289/EHP2566. |
| doi_str_mv | 10.1289/EHP2566 |
| format | Article |
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We evaluated the prospective association of arsenic exposure and metabolism with type 2 diabetes and insulin resistance.
We included 1,838 American Indian men and women free of diabetes (median age, 36 y). Arsenic exposure was assessed as the sum of inorganic arsenic (iAs), monomethylarsonate (MMA), and dimethylarsinate (DMA) urine concentrations (ΣAs). Arsenic metabolism was evaluated by the proportions of iAs, MMA, and DMA over their sum (iAs%, MMA%, and DMA%). Homeostasis model assessment for insulin resistance (HOMA2-IR) was measured at baseline and follow-up visits. Incident diabetes was evaluated at follow-up.
Median ΣAs, iAs%, MMA%, and DMA% was 4.4 μg/g creatinine, 9.5%, 14.4%, and 75.6%, respectively. Over 10,327 person-years of follow-up, 252 participants developed diabetes. Median HOMA2-IR at baseline was 1.5. The fully adjusted hazard ratio [95% confidence interval (CI)] for incident diabetes per an interquartile range increase in ΣAs was 1.57 (95% CI: 1.18, 2.08) in participants without prediabetes at baseline. Arsenic metabolism was not associated with incident diabetes. ΣAs was positively associated with HOMA2-IR at baseline but negatively with HOMA2-IR at follow-up. Increased MMA% was associated with lower HOMA2-IR when either iAs% or DMA% decreased. The association of arsenic metabolism with HOMA2-IR differed by B-vitamin intake and
genetics variants.
Among participants without baseline prediabetes, arsenic exposure was associated with incident diabetes. Low MMA% was cross-sectional and prospectively associated with higher HOMA2-IR. Research is needed to confirm possible interactions of arsenic metabolism with B vitamins and
variants on diabetes risk. https://doi.org/10.1289/EHP2566.</description><identifier>ISSN: 0091-6765</identifier><identifier>EISSN: 1552-9924</identifier><identifier>DOI: 10.1289/EHP2566</identifier><identifier>PMID: 29373862</identifier><language>eng</language><publisher>United States: National Institute of Environmental Health Sciences</publisher><subject>Adult ; Arsenic ; Arsenic - urine ; Biomarkers ; Body mass index ; Cacodylic Acid - urine ; Cardiovascular disease ; Confidence intervals ; Creatinine ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes research ; Diagnosis ; Environmental Exposure ; Environmental Pollutants - urine ; Exposure ; Family health ; Family studies ; Fasting ; Female ; Genetics ; Glucose ; Health aspects ; Health risk assessment ; Health risks ; Homeostasis ; Humans ; Incidence ; Indians, North American ; Insulin ; Insulin Resistance ; Male ; Metabolism ; Middle Aged ; Native North Americans ; Polymethyl methacrylate ; Population ; Prospective Studies ; Toxicity ; United States - epidemiology ; Urine ; Vitamin B ; Vitamins ; Young Adult</subject><ispartof>Environmental health perspectives, 2017-12, Vol.125 (12), p.127004</ispartof><rights>COPYRIGHT 2017 National Institute of Environmental Health Sciences</rights><rights>Copyright National Institute of Environmental Health Sciences Dec 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c601t-52756d9612cc6de10a402e9e43bc6e85f24b4ec2834b8e966938c51666b014a53</citedby><cites>FETCH-LOGICAL-c601t-52756d9612cc6de10a402e9e43bc6e85f24b4ec2834b8e966938c51666b014a53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963590/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963590/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29373862$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grau-Perez, Maria</creatorcontrib><creatorcontrib>Kuo, Chin-Chi</creatorcontrib><creatorcontrib>Gribble, Matthew O</creatorcontrib><creatorcontrib>Balakrishnan, Poojitha</creatorcontrib><creatorcontrib>Jones Spratlen, Miranda</creatorcontrib><creatorcontrib>Vaidya, Dhananjay</creatorcontrib><creatorcontrib>Francesconi, Kevin A</creatorcontrib><creatorcontrib>Goessler, Walter</creatorcontrib><creatorcontrib>Guallar, Eliseo</creatorcontrib><creatorcontrib>Silbergeld, Ellen K</creatorcontrib><creatorcontrib>Umans, Jason G</creatorcontrib><creatorcontrib>Best, Lyle G</creatorcontrib><creatorcontrib>Lee, Elisa T</creatorcontrib><creatorcontrib>Howard, Barbara V</creatorcontrib><creatorcontrib>Cole, Shelley A</creatorcontrib><creatorcontrib>Navas-Acien, Ana</creatorcontrib><title>Association of Low-Moderate Arsenic Exposure and Arsenic Metabolism with Incident Diabetes and Insulin Resistance in the Strong Heart Family Study</title><title>Environmental health perspectives</title><addtitle>Environ Health Perspect</addtitle><description>High arsenic exposure has been related to diabetes, but at low-moderate levels the evidence is mixed. Arsenic metabolism, which is partly genetically controlled and may rely on certain B vitamins, plays a role in arsenic toxicity.
We evaluated the prospective association of arsenic exposure and metabolism with type 2 diabetes and insulin resistance.
We included 1,838 American Indian men and women free of diabetes (median age, 36 y). Arsenic exposure was assessed as the sum of inorganic arsenic (iAs), monomethylarsonate (MMA), and dimethylarsinate (DMA) urine concentrations (ΣAs). Arsenic metabolism was evaluated by the proportions of iAs, MMA, and DMA over their sum (iAs%, MMA%, and DMA%). Homeostasis model assessment for insulin resistance (HOMA2-IR) was measured at baseline and follow-up visits. Incident diabetes was evaluated at follow-up.
Median ΣAs, iAs%, MMA%, and DMA% was 4.4 μg/g creatinine, 9.5%, 14.4%, and 75.6%, respectively. Over 10,327 person-years of follow-up, 252 participants developed diabetes. Median HOMA2-IR at baseline was 1.5. The fully adjusted hazard ratio [95% confidence interval (CI)] for incident diabetes per an interquartile range increase in ΣAs was 1.57 (95% CI: 1.18, 2.08) in participants without prediabetes at baseline. Arsenic metabolism was not associated with incident diabetes. ΣAs was positively associated with HOMA2-IR at baseline but negatively with HOMA2-IR at follow-up. Increased MMA% was associated with lower HOMA2-IR when either iAs% or DMA% decreased. The association of arsenic metabolism with HOMA2-IR differed by B-vitamin intake and
genetics variants.
Among participants without baseline prediabetes, arsenic exposure was associated with incident diabetes. Low MMA% was cross-sectional and prospectively associated with higher HOMA2-IR. Research is needed to confirm possible interactions of arsenic metabolism with B vitamins and
variants on diabetes risk. https://doi.org/10.1289/EHP2566.</description><subject>Adult</subject><subject>Arsenic</subject><subject>Arsenic - urine</subject><subject>Biomarkers</subject><subject>Body mass index</subject><subject>Cacodylic Acid - urine</subject><subject>Cardiovascular disease</subject><subject>Confidence intervals</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes research</subject><subject>Diagnosis</subject><subject>Environmental Exposure</subject><subject>Environmental Pollutants - urine</subject><subject>Exposure</subject><subject>Family health</subject><subject>Family studies</subject><subject>Fasting</subject><subject>Female</subject><subject>Genetics</subject><subject>Glucose</subject><subject>Health aspects</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Homeostasis</subject><subject>Humans</subject><subject>Incidence</subject><subject>Indians, North American</subject><subject>Insulin</subject><subject>Insulin Resistance</subject><subject>Male</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Native North Americans</subject><subject>Polymethyl methacrylate</subject><subject>Population</subject><subject>Prospective Studies</subject><subject>Toxicity</subject><subject>United States - epidemiology</subject><subject>Urine</subject><subject>Vitamin B</subject><subject>Vitamins</subject><subject>Young 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T</au><au>Howard, Barbara V</au><au>Cole, Shelley A</au><au>Navas-Acien, Ana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of Low-Moderate Arsenic Exposure and Arsenic Metabolism with Incident Diabetes and Insulin Resistance in the Strong Heart Family Study</atitle><jtitle>Environmental health perspectives</jtitle><addtitle>Environ Health Perspect</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>125</volume><issue>12</issue><spage>127004</spage><pages>127004-</pages><issn>0091-6765</issn><eissn>1552-9924</eissn><abstract>High arsenic exposure has been related to diabetes, but at low-moderate levels the evidence is mixed. Arsenic metabolism, which is partly genetically controlled and may rely on certain B vitamins, plays a role in arsenic toxicity.
We evaluated the prospective association of arsenic exposure and metabolism with type 2 diabetes and insulin resistance.
We included 1,838 American Indian men and women free of diabetes (median age, 36 y). Arsenic exposure was assessed as the sum of inorganic arsenic (iAs), monomethylarsonate (MMA), and dimethylarsinate (DMA) urine concentrations (ΣAs). Arsenic metabolism was evaluated by the proportions of iAs, MMA, and DMA over their sum (iAs%, MMA%, and DMA%). Homeostasis model assessment for insulin resistance (HOMA2-IR) was measured at baseline and follow-up visits. Incident diabetes was evaluated at follow-up.
Median ΣAs, iAs%, MMA%, and DMA% was 4.4 μg/g creatinine, 9.5%, 14.4%, and 75.6%, respectively. Over 10,327 person-years of follow-up, 252 participants developed diabetes. Median HOMA2-IR at baseline was 1.5. The fully adjusted hazard ratio [95% confidence interval (CI)] for incident diabetes per an interquartile range increase in ΣAs was 1.57 (95% CI: 1.18, 2.08) in participants without prediabetes at baseline. Arsenic metabolism was not associated with incident diabetes. ΣAs was positively associated with HOMA2-IR at baseline but negatively with HOMA2-IR at follow-up. Increased MMA% was associated with lower HOMA2-IR when either iAs% or DMA% decreased. The association of arsenic metabolism with HOMA2-IR differed by B-vitamin intake and
genetics variants.
Among participants without baseline prediabetes, arsenic exposure was associated with incident diabetes. Low MMA% was cross-sectional and prospectively associated with higher HOMA2-IR. Research is needed to confirm possible interactions of arsenic metabolism with B vitamins and
variants on diabetes risk. https://doi.org/10.1289/EHP2566.</abstract><cop>United States</cop><pub>National Institute of Environmental Health Sciences</pub><pmid>29373862</pmid><doi>10.1289/EHP2566</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0091-6765 |
| ispartof | Environmental health perspectives, 2017-12, Vol.125 (12), p.127004 |
| issn | 0091-6765 1552-9924 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5963590 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; JSTOR Archive Collection A-Z Listing; PubMed Central |
| subjects | Adult Arsenic Arsenic - urine Biomarkers Body mass index Cacodylic Acid - urine Cardiovascular disease Confidence intervals Creatinine Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - epidemiology Diabetes research Diagnosis Environmental Exposure Environmental Pollutants - urine Exposure Family health Family studies Fasting Female Genetics Glucose Health aspects Health risk assessment Health risks Homeostasis Humans Incidence Indians, North American Insulin Insulin Resistance Male Metabolism Middle Aged Native North Americans Polymethyl methacrylate Population Prospective Studies Toxicity United States - epidemiology Urine Vitamin B Vitamins Young Adult |
| title | Association of Low-Moderate Arsenic Exposure and Arsenic Metabolism with Incident Diabetes and Insulin Resistance in the Strong Heart Family Study |
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