BackgroundChronic exposure to high level of inorganic arsenic in drinking water has been associated with Type 2 Diabetes (T2D). Most research has been ecological in nature and has focused on high levels of arsenic exposure with few studies directly measuring arsenic levels in drinking water as an index of arsenic exposure. The effect of low to moderate levels of arsenic exposure on diabetes risk is largely unknown thus our study is adding further knowledge over previous works.MethodsThis cross sectional study was conducted in 1004 consenting women and men from 1682 eligible participants yielding a participation rate of 60%. These participants are aged >30 years and were living in Bangladesh and had continuously consumed arsenic-contaminated drinking water for at least 6 months. T2D cases were diagnosed using glucometer following the new diagnostic criteria (Fasting Blood Glucose > 126 mg/dl) from the WHO guideline (WHO 2006), or a self-reported physician diagnosis of type 2 diabetes. Association between T2D and chronic arsenic exposure was estimated by multiple logistic regression with adjustment for age, sex, education, Body Mass Index (BMI) and family history of T2D.ResultsA total of 1004 individuals participated in the study. The prevalence of T2D was 9% (95% CI 7-11%). After adjustment for diabetes risk factors, an increased risk of type 2 diabetes was observed for arsenic exposure over 50 μg/L with those in the highest category having almost double the risk of type 2 diabetes (OR=1.9 ; 95% CI 1.1-3.5). For most levels of arsenic exposure, the risk estimates are higher with longer exposure; a dose–response pattern was also observed.ConclusionsThese findings suggest an association between chronic arsenic exposure through drinking water and T2D. Risks are generally higher with longer duration of arsenic exposure. The risk of T2D is highest among those who were exposed to the highest concentration of arsenic for more than 10 years.
Objective: To determine the association between chronic arsenic exposure via drinking water and prevalence of hypertension among rural Bangladeshi adults. Design, Setting, Participants: This is an analytical cross sectional study among 1004 participants from 1682 eligible men and women (Participation rate 60%) aged >30 years living in Bangladesh who had continuously consumed arsenic-contaminated drinking water for at least 6 months. Main Outcome Measures: Hypertension was defined as systolic blood pressure > 140 mm of Hg or a diastolic blood pressure > 90 mm of Hg or in combination of the both. Results: A total of 1004 individuals participated in the study. The prevalence of hypertension was 6.6% (95% CI 5.1-8.3%). After adjustment for participant’s age, sex, education, religion, marital status, sign of arsenical skin lesions, monthly household income and BMI, no excess risk of hypertension was observed for drinking water arsenic exposure over 50μg/L. Also, there was no increased risk for higher concentration of arsenic in the drinking water. Arsenic concentration >50 μg/L in drinking water showed no association with systolic, diastolic hypertension separately however, it shows a strong relationship with increased pulse pressure when pulse pressure categorized as <55 and ≥55 mmHg (Adjusted OR: 3.06, CI: 1.22-7.65). Also, duration of exposure to arsenic didn’t show any impact on an increased risk to hypertension except pulse pressure when exposed to arsenic for ≥10 years (Adjusted OR: 4.74, CI: 1.25-17.88). Conclusion: Unlike other studies conducted in developing countries that reported a significant association, this study suggests no association between higher drinking water arsenic concentration and hypertension except for pulse pressure.
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