期刊
DIABETES CARE
卷 38, 期 4, 页码 620-627出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc14-1641
关键词
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资金
- National Heart, Lung, and Blood Institute [R01-HL-090863, HL-41642, HL-41652, HL-41654, HL-65521]
- National Institute of Environmental Health Sciences [R01-ES-021367, P30-ES-03819]
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [U01HL041642, U01HL041654, U01HL041652, R01HL109284, U01HL065521, R01HL090863] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES [R01ES021367, P30ES003819] Funding Source: NIH RePORTER
OBJECTIVELittle is known about arsenic metabolism in diabetes development. We investigated the prospective associations of low-moderate arsenic exposure and arsenic metabolism with diabetes incidence in the Strong Heart Study.RESEARCH DESIGN AND METHODSA total of 1,694 diabetes-free participants aged 45-75 years were recruited in 1989-1991 and followed through 1998-1999. We used the proportions of urine inorganic arsenic (iAs), monomethylarsonate (MMA), and dimethylarsinate (DMA) over their sum (expressed as iAs%, MMA%, and DMA%) as the biomarkers of arsenic metabolism. Diabetes was defined as fasting glucose 126 mg/dL, 2-h glucose 200 mg/dL, self-reported diabetes history, or self-reported use of antidiabetic medications.RESULTSOver 11,263.2 person-years of follow-up, 396 participants developed diabetes. Using the leave-one-out approach to model the dynamics of arsenic metabolism, we found that lower MMA% was associated with higher diabetes incidence. The hazard ratios (95% CI) of diabetes incidence for a 5% increase in MMA% were 0.77 (0.63-0.93) and 0.82 (0.73-0.92) when iAs% and DMA%, respectively, were left out of the model. DMA% was associated with higher diabetes incidence only when MMA% decreased (left out of the model) but not when iAs% decreased. iAs% was also associated with higher diabetes incidence when MMA% decreased. The association between MMA% and diabetes incidence was similar by age, sex, study site, obesity, and urine iAs concentrations.CONCLUSIONSArsenic metabolism, particularly lower MMA%, was prospectively associated with increased incidence of diabetes. Research is needed to evaluate whether arsenic metabolism is related to diabetes incidence per se or through its close connections with one-carbon metabolism.
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