Arsenic exposure is associated with diminished insulin sensitivity in non-diabetic Amish adults

作者:Park Sung Kyun*; Peng Qing; Bielak Lawrence F; Silver Kristi D; Peyser Patricia A; Mitchell Braxton D
来源:DIABETES-METABOLISM RESEARCH AND REVIEWS, 2016, 32(6): 565-571.
DOI:10.1002/dmrr.2769

摘要

Background Substantial evidence supports an association between diabetes and arsenic at high exposure levels, but results are mixed at low exposure levels. The aetiology of diabetes involves insulin resistance and beta-cell dysfunction. However, only a few epidemiologic studies have examined measures of insulin resistance and beta-cell function in relation to arsenic exposure, and no studies have tested for associations with the oral glucose tolerance test (OGTT). We examined the association between urinary total arsenic and OGTT-based markers of insulin sensitivity and beta-cell function. Methods We studied 221 non-diabetic adults (mean age=52.5 years) from the Amish Family Diabetes Study. We computed OGTT-based validated measures of insulin sensitivity and beta-cell function. Generalized estimating equations accounting for sibship were used to estimate associations. Results After adjusting for age, sex, waist-to-hip ratio and urinary creatinine, an interquartile range increase in urinary total arsenic (6.24 mu g/L) was significantly, inversely associated with two insulin sensitivitymeasures (Stumvoll metabolic clearance rate=-0.23 mg/(kg min), (95% CI: -0.38, -0.089), p=0.0015; Stumvoll insulin sensitivity index=-0.0029 mu mol/(kg min pM), (95% CI: -0.0047, -0.0011), p=0.0015). Urinary total arsenic was also significantly associated with higher fasting glucose levels (0.57 mg/dL (95% CI: 0.06, 1.09) per interquartile range increase, p=0.029). No significant associations were found between urinary total arsenic and beta-cell function measures. Conclusions This preliminary study found that urinary total arsenic was associated with insulin sensitivity but not beta-cell function measures, suggesting that low-level arsenic exposure may influence diabetes risk through impairing insulin sensitivity.

  • 出版日期2016-9