J Korean Med Sci.  2013 Jun;28(6):861-868. 10.3346/jkms.2013.28.6.861.

Arsenic Exposure and Prevalence of Diabetes Mellitus in Korean Adults

• Rhee SY
• Hwang YC
• Woo JT
• Chin SO
• Chon S
• Kim YS

• KMID: 2158033
• DOI: http://doi.org/10.3346/jkms.2013.28.6.861

Abstract

It has been suggested that there is an association between environmental, low-level arsenic exposure and the risk of diabetes mellitus (DM), but little research has been conducted. Here, the glucose tolerance status and urinary creatinine adjusted total arsenic concentrations were analyzed in 3,602 subjects > or = 20 yr of age who were registered for the Korea National Health and Nutrition Examination Survey, 2008-2009. Various demographic parameters were associated with urinary arsenic concentrations. After adjusting for these variables, urinary arsenic concentrations in subjects with DM were significantly higher than those in subjects with normal glucose tolerance and those with impaired fasting glucose (P < 0.001). Compared with the lowest quartile ( < 70.7 microg/g creatinine), the odds ratios and 95% confidence intervals for DM were 1.11 (0.73-1.68), 1.42 (0.94-2.13), and 1.56 (1.03-2.36) for urinary arsenic concentrations of 70.7 to < 117.7, 117.7 to < 193.4, and > or = 193.4 microg/g creatinine, respectively, following multivariate adjustment. Furthermore, the urinary total arsenic concentration was inversely associated with the insulin secretion index, HOMA2 %B (beta = -0.033, P = 0.032). These findings suggest that arsenic exposure, possibly involving beta cell dysfunction, is associated with an increased risk of DM in the Korean population.

Keyword

Diabetes Mellitus; Arsenic; Arsenic Poisoning; Hyperglycemia; Blood Glucose; Insulin Resistance; Korea; KNHANES

MeSH Terms

Adult
Alcohol Drinking
Arsenic/*urine
Asian Continental Ancestry Group
Blood Glucose/analysis
Diabetes Mellitus/*epidemiology/etiology
Female
Glucose Tolerance Test
Humans
Insulin/metabolism
Insulin Resistance
Male
Middle Aged
Nutrition Surveys
Odds Ratio
Prevalence
Republic of Korea/epidemiology
Risk Factors
Smoking
Blood Glucose
Insulin
Arsenic

Figure

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  Fig. 1 Urinary total arsenic concentrations according to glucose tolerance status adjusted for all other significant variables. ANCOVA. Geometric mean with 95% confidence interval. *P < 0.01 by post-hoc analysis.

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  Fig. 2 Prevalence of IFG and DM according to total urinary arsenic concentration quartile. P for trend by linear-by-linear association.

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