TY  - BOOK
AU  - Howard, Barbara V
AU  - Umans, Jason G
TI  - Arsenic exposure, arsenic metabolism, and incident diabetes in the strong heart study
SN  - 0149-5992
KW  - *Arsenic/me [Metabolism]
KW  - *Arsenic/to [Toxicity]
KW  - *Diabetes Mellitus, Type 2/ep [Epidemiology]
KW  - *Diabetes Mellitus, Type 2/me [Metabolism]
KW  - *Environmental Exposure/sn [Statistics & Numerical Data]
KW  - *Indians, North American/sn [Statistics & Numerical Data]
KW  - Aged
KW  - Arizona/ep [Epidemiology]
KW  - Arsenic/ur [Urine]
KW  - Biological Markers/me [Metabolism]
KW  - Biological Markers/ur [Urine]
KW  - Cohort Studies
KW  - Diabetes Mellitus, Type 2/dt [Drug Therapy]
KW  - Diabetes Mellitus, Type 2/ur [Urine]
KW  - Environmental Exposure/ae [Adverse Effects]
KW  - Female
KW  - Humans
KW  - Hypoglycemic Agents/tu [Therapeutic Use]
KW  - Incidence
KW  - Male
KW  - Middle Aged
KW  - North Dakota/ep [Epidemiology]
KW  - Oklahoma/ep [Epidemiology]
KW  - Prospective Studies
KW  - South Dakota/ep [Epidemiology]
KW  - MedStar Health Research Institute
KW  - Journal Article
KW  - Research Support, N.I.H., Extramural
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - CONCLUSIONS: Arsenic metabolism, particularly lower MMA%, was prospectively associated with increased incidence of diabetes. Research is needed to evaluate whether arsenic metabolism is related to diabetes incidence per se or through its close connections with one-carbon metabolism.Copyright � 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered; OBJECTIVE: Little is known about arsenic metabolism in diabetes development. We investigated the prospective associations of low-moderate arsenic exposure and arsenic metabolism with diabetes incidence in the Strong Heart Study; RESEARCH DESIGN AND METHODS: A total of 1,694 diabetes-free participants aged 45-75 years were recruited in 1989-1991 and followed through 1998-1999. We used the proportions of urine inorganic arsenic (iAs), monomethylarsonate (MMA), and dimethylarsinate (DMA) over their sum (expressed as iAs%, MMA%, and DMA%) as the biomarkers of arsenic metabolism. Diabetes was defined as fasting glucose > 126 mg/dL, 2-h glucose > 200 mg/dL, self-reported diabetes history, or self-reported use of antidiabetic medications; RESULTS: Over 11,263.2 person-years of follow-up, 396 participants developed diabetes. Using the leave-one-out approach to model the dynamics of arsenic metabolism, we found that lower MMA% was associated with higher diabetes incidence. The hazard ratios (95% CI) of diabetes incidence for a 5% increase in MMA% were 0.77 (0.63-0.93) and 0.82 (0.73-0.92) when iAs% and DMA%, respectively, were left out of the model. DMA% was associated with higher diabetes incidence only when MMA% decreased (left out of the model) but not when iAs% decreased. iAs% was also associated with higher diabetes incidence when MMA% decreased. The association between MMA% and diabetes incidence was similar by age, sex, study site, obesity, and urine iAs concentrations
UR  - http://dx.doi.org/10.2337/dc14-1641
ER  -