urinary arsenic and diabetes type2

[Guest guest]

Article abstract & my comment follow the news article.

- - - -

Arsenic Map: http://water.usgs.gov/nawqa/trace/arsenic/

EPA: http://www.epa.gov/safewater/arsenic/index.html

JAMA article not free online:

Arsenic Exposure and Prevalence of Type 2 Diabetes in US Adults

<http://jama.ama-assn.org/cgi/content/short/300/7/814>

- - - -

Trace arsenic in water may be linked with diabetes

By CARLA K. JOHNSON Associated Press Writer

08/19/2008 11:25:35 PM MDT

http://www.denverpost.com/healthcare/ci_10246387

CHICAGO---A new analysis of government data is the first to link

low-level arsenic exposure, possibly from drinking water, with Type 2

diabetes, researchers say. The study's limitations make more research

necessary. And public water systems were on their way to meeting tougher

U.S. arsenic standards as the data were collected.

Still, the analysis of 788 adults' medical tests found a nearly fourfold

increase in the risk of diabetes in people with low arsenic

concentrations in their urine compared to people with even lower levels.

Previous research outside the United States has linked high levels of

arsenic in drinking water with diabetes. It's the link at low levels

that's new. The findings appear in Wednesday's Journal of the American

Medical Association.

" The good news is, this is preventable, " said lead author Dr. Ana

Navas-Acien of s Hopkins Bloomberg School of Public Health in Baltimore.

New safe drinking water standards may be needed if the findings are

duplicated in future studies, Navas-Acien said. She said they've begun a

new study of 4,000 people.

Arsenic can get into drinking water naturally when minerals dissolve. It

is also an industrial pollutant from coal burning and copper smelting.

Utilities use filtration systems to get it out of drinking water.

Seafood also contains nontoxic organic arsenic. The researchers adjusted

their analysis for signs of seafood intake and found that people with

Type 2 diabetes had 26 percent higher inorganic arsenic levels than

people without Type 2 diabetes.

How arsenic could contribute to diabetes is unknown, but prior studies

have found impaired insulin secretion in pancreas cells treated with an

arsenic compound.

The policy implications of the new findings are unclear, said Molly

Kile, an environmental health research scientist at the Harvard School

of Public Health. Kile wrote an accompanying editorial in the journal.

" Urinary arsenic reflects exposures from all routes---air, water and

food---which makes it difficult to track the actual source of arsenic

exposure let alone use the results from this study to establish drinking

water standards, " Kile said.

Also, the findings raise a chicken-and-egg problem, she said, since it's

unknown whether diabetes changes the way people metabolize arsenic. It's

possible that people with diabetes excrete more arsenic.

The United States lowered arsenic standards for public water systems to

10 parts per billion in 2001 because of known cancer risks. Compliance

was required by 2006, years after the study data were collected in 2003

and 2004.

- - - -

Trace arsenic and other pollutants -> diabetes

Post by Binstock on Wed Aug 20, 2008 6:52 am

The relationship between arsenic and diabetes is important, even as

associations between diabetes and other environmental pollutants have

been described in peer reviewed science articles. Here are several

titles of findings from a large CDC data base. Each article's full

citation is findable in PubMed. Several of the articles are free online.

1. A strong dose-response relation between serum concentrations of

persistent organic pollutants and diabetes: results from the National

Health and Examination Survey 1999-2002

2. Association of Brominated Flame Retardants with Diabetes and

Metabolic syndrome in the United States Population: 2003-2004.

3. Association between serum concentrations of persistent organic

pollutants and insulin resistance among nondiabetic adults: results from

the National Health and Nutrition Examination Survey 1999-2002

4. Relationship between serum concentrations of persistent organic

pollutants and the prevalence of metabolic syndrome among non-diabetic

adults: results from the National Health and Nutrition Examination

Survey 1999-2002.

- - - -

Arsenic Exposure and Prevalence of Type 2 Diabetes in US Adults

Ana Navas-Acien, MD, PhD; Ellen K. Silbergeld, PhD; o

Pastor-Barriuso, PhD; Eliseo Guallar, MD, DrPH

JAMA. 2008;300(7):814-822.

Context High chronic exposure to inorganic arsenic in drinking water

has been related to diabetes development, but the effect of exposure to

low to moderate levels of inorganic arsenic on diabetes risk is unknown.

In contrast, arsenobetaine, an organic arsenic compound derived from

seafood intake, is considered nontoxic.

Objective To investigate the association of arsenic exposure, as

measured in urine, with the prevalence of type 2 diabetes in a

representative sample of US adults.

Design, Setting, and Participants Cross-sectional study in 788 adults

aged 20 years or older who participated in the 2003-2004 National Health

and Nutrition Examination Survey (NHANES) and had urine arsenic

determinations.

Main Outcome Measure Prevalence of type 2 diabetes across intake of

arsenic.

Results The median urine levels of total arsenic, dimethylarsinate, and

arsenobetaine were 7.1, 3.0, and 0.9 µg/L, respectively. The prevalence

of type 2 diabetes was 7.7%. After adjustment for diabetes risk factors

and markers of seafood intake, participants with type 2 diabetes had a

26% higher level of total arsenic (95% confidence interval [CI],

2.0%-56.0%) and a nonsignificant 10% higher level of dimethylarsinate

(95% CI, --8.0% to 33.0%) than participants without type 2 diabetes, and

levels of arsenobetaine were similar to those of participants without

type 2 diabetes. After similar adjustment, the odds ratios for type 2

diabetes comparing participants at the 80th vs the 20th percentiles were

3.58 for the level of total arsenic (95% CI, 1.18-10.83), 1.57 for

dimethylarsinate (95% CI, 0.89-2.76), and 0.69 for arsenobetaine (95%

CI, 0.33-1.48).

Conclusions After adjustment for biomarkers of seafood intake, total

urine arsenic was associated with increased prevalence of type 2

diabetes. This finding supports the hypothesis that low levels of

exposure to inorganic arsenic in drinking water, a widespread exposure

worldwide, may play a role in diabetes prevalence. Prospective studies

in populations exposed to a range of inorganic arsenic levels are needed

to establish whether this association is causal.

Author Affiliations: Department of Environmental Health Sciences (Drs

Navas-Acien and Silbergeld), and Department of Epidemiology, and Welch

Center for Prevention, Epidemiology, and Clinical Research (Drs

Navas-Acien and Guallar), s Hopkins Bloomberg School of Public

Health, Baltimore, land; National Center for Epidemiology, Instituto

de Salud III, Madrid, Spain, and CIBER en Epidemiología y Salud

Pública, Madrid, Spain (Dr Pastor-Barriuso); Department of

Cardiovascular Epidemiology and Population Genetics, Centro Nacional de

Investigaciones Cardiovasculares, Madrid, Spain, and Department of

Medicine, s Hopkins Medical Institutions, Baltimore (Dr Guallar).