Urinary Inorganic Arsenic Concentration and Type 2 Diabetes Mellitus and Hypertension Development: A Population-Based Analysis in Arica, Chile

Abstract

Introduction: Studies that evaluated the association between type 2 diabetes mellitus and hypertension has been consistent in population exposed to high levels of arsenic. However, the evidence is no clear regarding low levels of exposure. The aim of this study was to explore the association between the concentration of inorganic arsenic in urine and the development of type 2 diabetes mellitus and hypertension. Methods: Data analysis of 10.340 individuals over the age of 14, of the population register of people exposed to polymetals, evaluated between 2009 and 2015. Outcome variable: Self-report of diagnosis of type 2 diabetes mellitus (T2DM) and hypertension (HBP). Exposure variable: Concentration of inorganic arsenic in urine. To evaluate association, we used multiple logistic regression models adjusted for creatinine, age, and body mass index. Results: Average age 40 years. The prevalence of diabetes was 8% (CI95% 0.073-0.085) and hypertension 15% (CI95% 0.143-0.159), (31% lost data). The median of inorganic arsenic was 18 μg/L (p25-p75 11-27 μg/L). The adjusted model showed a modest association between inorganic arsenic and T2DM (OR: 1.008, 95% CI 1.003-1.013). Regarding the relationship with HBP, the association was not significant (OR: 0.99, IC95% 0.993-1.004). Conclusion: The results support the hypothesis that low levels of arsenic exposure could be associated with T2DM; however, should be considered with caution due limitations as the way of measuring the outcome variable, the % of lost data and the lack of information from other confounding.