American Journal of Epidemiology Vol. 139, No. 5: 484-492
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
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Ingested Inorganic Arsenic and Prevalence of Diabetes Mellitus
1Department of Family Medicine, National Taiwan University College of Medicine Taipei, Taiwan
2Department of Public Health, School of Medicine, Taipei Medical College Taipei, Taiwan
3Institute of Public Health, National Taiwan University College of Public Health Taipei, Taiwan
4Institute of Biomedical Sciences, Academia Sinica Taipei, Taiwan
5Department of Legal Medicine, National Taiwan University College of Medicine Taipei, Taiwan
6Department of Epidemiology, The Johns Hopkins University School of Hygiene and Public Health Baltimore, MD
7Department of Internal Medicine, National Taiwan University College of Medicine Taipei, Taiwan
Reprint requests to Dr. Chien-Jen Chen, Institute of Public Health, National Taiwan University College of Public Health, 1, Jen-Ai Road Section 1, Taipei 10018, Taiwan, Republic of China
To examine the association between ingested inorganic arsenic and prevalence of diabetes mellitus, in 1988, the authors studied 891 adults residing in villages in southern Taiwan where arseniasis is hyperendemic. The status of diabetes mellitus was determined by an oral glucose tolerance test and a history of diabetes regularly treated with sulfonylurea or insulin. The cumulative arsenic exposure in parts per million-years was calculated from the detailed history of residential addresses and duration of drinking artesian well water obtained through standardized interviews based on a structured questionnaire and the arsenic concentration in well water. The body mass index was derived from body height and weight measured according to a standard protocol, while the physical activity at work was also obtained by questionnaire interviews. Residents in villages where the chronic arseniasis was hyperendemic had a twofold increase in age-and sex-adjusted prevalence of diabetes mellitus compared with residents in Taipei City and the Taiwan area. There was a dose-response relation between cumulative arsenic exposure and prevalence of diabetes mellitus. The relation remained significant after adjustment for age, sex, body mass index, and activity level at work by a multiple logistic regression analysis giving a multivariate-adjusted odds ratio of 6.61 and 10.05, respectively, for those who had a cumulative arsenic exposure of 0.1–15.0 and greater than 15.0 ppm-year compared with those who were unexposed. These results suggest the chronic arsenic exposure may induce diabetes mellitus in humans.
arsenic; diabetes mellitus; water; water pollutants
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