Rejoinder: Arsenic exposure and prevalence of type 2 diabetes: updated findings from the National Health Nutrition and Examination Survey, 2003-2006.

作者: Ana Navas-Acien , Ellen K. Silbergeld , Roberto Pastor-Barriuso , Eliseo Guallar

DOI: 10.1097/EDE.0B013E3181AFEF88

关键词:

摘要: The role of inorganic arsenic exposure in chronic diseases, including type 2 diabetes, is a major public health research question. This has been underscored by recent epidemiologic1-4 and experimental5-8 evidence supporting increased risks at low levels. In this context, it critical to understand the biology technical limitations biomarkers exposure, usually measured urine.9-11 Total urine integrates from multiple sources (arsenite, arsenate) organic (mainly arsenobetaine, arsenosugars arsenolipids) compounds their metabolites (Figure 1). population-based studies, speciation important differentiate because arsenicals, mostly found seafood, have little toxicity relative its metabolites. Despite analytic advances measurement arsenosugars, arsenolipids metabolites,9 determination remains technically challenging epidemiologic studies. For example, those were not 2003-2004 National Health Nutrition Examination Survey (NHANES). Moreover, arsenite, arsenate methylarsonate—species that directly reflect metabolism 1)—were NHANES with high limits detection,9,12-14 only total arsenic, dimethylarsinate, arsenobetaine arsenocholine (a minor seafood arsenical) available for analyses endpoints. Figure 1 Inorganic exposure: relevant general population, source urine. 2003-2004, arsenate, methylarsonate (MA) below limit detection 96%, 94%, 65% 98% ... To evaluate association prevalence diabetes 2003-2004,2 we reported two main strategies remove contribution arsenicals marine origin arsenic. First, conducted between adjusted sociodemographic factors, risk markers intake (urine blood mercury). More importantly, factors but restricted participants levels (ie unlikely intake, whom would be derived mainly arsenic). magnitude subgroup was similar analysis adjusting mercury, demonstrating identified whole sample driven dependent on statistical method used control origin. In reanalysis published issue EPIDEMIOLOGY, Steinmaus et al.15 minus (in 13 individuals detected) as an “estimate exposure,” attempt arsenocholine, however, inadequate estimate does other unmeasured seafood. Indeed, correlation remained moderately strong (r=0.51, Figure 2). Discussion, authors indicated after subtracting 24% variance remaining still explained “probably due some dimethylarsinate are present same seafoods contain arsenobetaine”.15 misclassification induced when estimating can further appreciated comparing distribution (20th, 50th 80th, 90th 99th percentiles 2.7, 6.0, 11.9, 18.4 73.6 μg/L, respectively) among undetectable (<0.4 μg/L) 1.9, 3.9, 7.7, 11.8 30.4 respectively). As consequence, any uses needs adjust such itself. Futhermore, using index aggravated categorical analyses, e.g. quintiles. Many highest quintile (≥80th percentile) exposed substantial amounts categorization situation could reduce efficacy adjustment multivariable models. Figure 2 Relationship (AB) (AC) 2003-2004. Arsenocholine subtracted detectable Lines represent dose-response relationships ... Given longstanding experience al. investigating effects difficult why exposure” without controlling conclusions. findings consistent out 2008 paper.2 (Table 3 manuscript).

参考文章(20)
Ana Navas-Acien, Ellen K Silbergeld, Roberto Pastor-Barriuso, Eliseo Guallar, Arsenic Exposure and Prevalence of Type 2 Diabetes in US Adults JAMA. ,vol. 300, pp. 814- 822 ,(2008) , 10.1001/JAMA.300.7.814
Hershel Jick, Douglas P. Chamberlin, Katrina Wilcox Hagberg, The origin and spread of a mumps epidemic: United Kingdom, 2003-2006. Epidemiology. ,vol. 20, pp. 656- 661 ,(2009) , 10.1097/EDE.0B013E3181B056F5
David S. Paul, Anne W. Harmon, Vicenta Devesa, David J. Thomas, Miroslav Stýblo, Molecular mechanisms of the diabetogenic effects of arsenic: inhibition of insulin signaling by arsenite and methylarsonous acid. Environmental Health Perspectives. ,vol. 115, pp. 734- 742 ,(2007) , 10.1289/EHP.9867
Kevin A. Francesconi, Doris Kuehnelt, Determination of arsenic species: A critical review of methods and applications, 2000–2003 Analyst. ,vol. 129, pp. 373- 395 ,(2004) , 10.1039/B401321M
Adam C Straub, Katherine A Clark, Mark A Ross, Ashwin G Chandra, Song Li, Xiang Gao, Patrick J Pagano, Donna B Stolz, Aaron Barchowsky, None, Arsenic-stimulated liver sinusoidal capillarization in mice requires NADPH oxidase–generated superoxide Journal of Clinical Investigation. ,vol. 118, pp. 3980- 3989 ,(2008) , 10.1172/JCI35092
Craig Steinmaus, Yan Yuan, Jane Liaw, Allan H. Smith, Low-level population exposure to inorganic arsenic in the United States and diabetes mellitus: a reanalysis. Epidemiology. ,vol. 20, pp. 807- 815 ,(2009) , 10.1097/EDE.0B013E3181B0FD29
M PYSHER, J SOLLOME, S REGAN, T CARDINAL, J HOYING, H BROOKS, R VAILLANCOURT, Increased hexokinase II expression in the renal glomerulus of mice in response to arsenic Toxicology and Applied Pharmacology. ,vol. 224, pp. 39- 48 ,(2007) , 10.1016/J.TAAP.2007.06.019
Angeline S. Andrew, David A. Jewell, Rebecca A. Mason, Michael L. Whitfield, Jason H. Moore, Margaret R. Karagas, Drinking-Water Arsenic Exposure Modulates Gene Expression in Human Lymphocytes from a U.S. Population Environmental Health Perspectives. ,vol. 116, pp. 524- 531 ,(2008) , 10.1289/EHP.10861
Chitra J. Amarasiriwardena, Adrienne S Ettinger, Joel David Schwartz, Howard Hu, Robert O. Wright, Marianne Hopkins, Ami R. Zota, Maternal arsenic exposure and impaired glucose tolerance during pregnancy. Environmental Health Perspectives. ,vol. 117, pp. 1059- 1064 ,(2009) , 10.1289/EHP0800533
Ana Navas-Acien, Jason G. Umans, Barbara V. Howard, Walter Goessler, Kevin A. Francesconi, Ciprian M. Crainiceanu, Ellen K. Silbergeld, Eliseo Guallar, Urine Arsenic Concentrations and Species Excretion Patterns in American Indian Communities Over a 10-year Period: The Strong Heart Study Environmental Health Perspectives. ,vol. 117, pp. 1428- 1433 ,(2009) , 10.1289/EHP.0800509