Exposure to arsenic in drinking water is associated with increased prevalence of diabetes a cross-sectional study in the Zimapán and Lagunera regions in Mexico.docVIP

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Exposure to arsenic in drinking water is associated with increased prevalence of diabetes a cross-sectional study in the Zimapán and Lagunera regions in Mexico.doc

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Exposure to arsenic in drinking water is associated with increased prevalence of diabetes a cross-sectional study in the Zimapán and Lagunera regions in Mexico

DelRazoetal.EnvironmentalHealth2011,10:73 /content/10/1/73 RESEARCH OpenAccess Exposuretoarsenicindrinkingwateris associatedwithincreasedprevalenceofdiabetes: across-sectionalstudyintheZimapánand LaguneraregionsinMexico LuzMDelRazo1,GonzaloGGarcía-Vargas2,OlgaLValenzuela1,ErikaHernándezCastellanos1, LuzCSánchez-Pe?a1,JennaMCurrier3,ZuzanaDrobná4,DanaLoomis5andMiroslavStyblo4* Abstract Background:Humanexposurestoinorganicarsenic(iAs)havebeenlinkedtoanincreasedriskofdiabetes mellitus.RecentlaboratorystudiesshowedthatmethylatedtrivalentmetabolitesofiAsmayplaykeyrolesinthe diabetogeniceffectsofiAs.OurstudyexaminedassociationsbetweenchronicexposuretoiAsindrinkingwater, metabolismofiAs,andprevalenceofdiabetesinarsenicosis-endemicareasofMexico. Methods:Weusedfastingbloodglucose(FBG),fastingplasmainsulin(FPI),oralglucosetolerancetest(OGTT), glycatedhemoglobin(HbA1c),andinsulinresistance(HOMA-IR)tocharacterizediabeticindividuals.Arseniclevels indrinkingwaterandurineweredeterminedtoestimateexposuretoiAs.UrinaryconcentrationsofiAsandits trivalentandpentavalentmethylatedmetabolitesweremeasuredtoassessiAsmetabolism.Associationsbetween diabetesandiAsexposureorurinarymetabolitesofiAswereestimatedbylogisticregressionwithadjustmentfor age,sex,hypertensionandobesity. Results:TheprevalenceofdiabeteswaspositivelyassociatedwithiAsindrinkingwater(OR1.13per10ppb,p 0.01)andwiththeconcentrationofdimethylarsinite(DMAsIII)inurine(OR1.24perinter-quartilerange,p=0.05). Notably,FPIandHOMA-IRwerenegativelyassociatedwithiAsexposure(b-2.08and-1.64,respectively,p0.01), suggestingthatthemechanismsofiAs-induceddiabetesdifferfromthoseunderlyingtype-2diabetes,whichis typicallycharacterizedbyinsulinresistance. Conclusions:Ourstudyconfirmsapreviouslyreported,butfrequentlyquestioned,associationbetweenexposure toiAsanddiabetes,andisthefirsttolinktheriskofdiabetestotheproductionofoneofthemosttoxic metabolitesofiAs,DMAsIII. Keywords:Arsenic,drinkingwater,diabetes,urinarymetabolitesofarsenic,dimethylarsinite