Association of Water Arsenic With Incident Diabetes in U.S. Adults: The Multi-Ethnic Study of Atherosclerosis and the Strong Heart Study

Author:

Spaur Maya1ORCID,Galvez-Fernandez Marta1,Chen Qixuan2,Lombard Melissa A.3,Bostick Benjamin C.4,Factor-Litvak Pam5,Fretts Amanda M.6,Shea Steven J.7,Navas-Acien Ana1,Nigra Anne E.1

Affiliation:

1. 1Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY

2. 2Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY

3. 3U.S. Geological Survey, New England Water Science Center, Pembroke, NH

4. 4Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY

5. 5Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY

6. 6Department of Epidemiology, University of Washington, Seattle, WA

7. 7Department of Medicine, Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY

Abstract

OBJECTIVE We examined the association of arsenic in federally regulated community water systems (CWS) and unregulated private wells with type 2 diabetes (T2D) incidence in the Strong Heart Family Study (SHFS), a prospective study of American Indian communities, and the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective study of racially and ethnically diverse urban U.S. communities. RESEARCH DESIGN AND METHODS We evaluated 1,791 participants from SHFS and 5,777 participants from MESA who had water arsenic estimates available and were free of T2D at baseline (2001–2003 and 2000–2002, respectively). Participants were followed for incident T2D until 2010 (SHFS cohort) or 2019 (MESA cohort). We used Cox proportional hazards mixed-effects models to account for clustering by family and residential zip code, with adjustment for sex, baseline age, BMI, smoking status, and education. RESULTS T2D incidence was 24.4 cases per 1,000 person-years (mean follow-up, 5.6 years) in SHFS and 11.2 per 1,000 person-years (mean follow-up, 14.0 years) in MESA. In a meta-analysis across the SHFS and MESA cohorts, the hazard ratio (95% CI) per doubling in CWS arsenic was 1.10 (1.02, 1.18). The corresponding hazard ratio was 1.09 (0.95, 1.26) in the SHFS group and 1.10 (1.01, 1.20) in the MESA group. The corresponding hazard ratio (95% CI) for arsenic in private wells and incident T2D in SHFS was 1.05 (0.95, 1.16). We observed statistical interaction and larger magnitude hazard ratios for participants with BMI <25 kg/m2 and female participants. CONCLUSIONS Low to moderate water arsenic levels (<10 µg/L) were associated with T2D incidence in the SHFS and MESA cohorts.

Funder

National Institute of Dental and Craniofacial Research

National Institute of Environmental Health Sciences

NIH Office of the Director

Eunice Kennedy Shriver National Institute of Child Health and Human Development

Publisher

American Diabetes Association

Reference40 articles.

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3. Cardiovascular health in American Indians and Alaska Natives: a scientific statement from the American Heart Association;Breathett,2020

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