Huang Ya-Li, Hsueh Yu-Mei, Huang Yung-Kai, Yip Ping-Keung, Yang Mo-Hsiung, Chen Chien-Jen
Department of Public Health, School of Medicine, Taipei Medical University, Taipei, Taiwan.
Sci Total Environ. 2009 Apr 1;407(8):2608-14. doi: 10.1016/j.scitotenv.2008.12.061. Epub 2009 Feb 1.
Long-term exposure to inorganic arsenic from artesian drinking well water is associated with carotid atherosclerosis in the Blackfoot Disease (BFD)-hyperendemic area in Taiwan. The current study examined the arsenic methylation capacity and its risk on carotid atherosclerosis. A total of 304 adults (158 men and 146 women) residing in the BFD-hyperendemic area were included. The extent of carotid atherosclerosis was assessed by duplex ultrasonography. Chronic arsenic exposure was estimated by an index of cumulative arsenic exposure (CAE) and the duration of artesian well water consumption. Urinary levels of inorganic arsenite [As(III)], arsenate [As(V)], monomethylarsonic acid [MMA(V)] and dimethylarsinic acid [DMA(V)] were determined by high performance liquid chromatography linked on-line to a hydride generator and atomic absorption spectrometry (HPLC-HG-AAS). The percentage of arsenic species, primary methylation index [PMI=MMA(V)/(As(III)+As(V)] and secondary methylation index [SMI=DMA(V)/MMA(V)] were calculated and employed as indicators of arsenic methylation capacity. Results showed that women and younger subjects had a more efficient arsenic methylation capacity than did men and the elderly. Carotid atherosclerosis cases had a significantly greater percentage of MMA(V) [%MMA(V)] and a lower percentage of DMA [%DMA (V)] compared to controls. Subjects in the highest two tertiles of PMI with a median of CAE >0 mg/L-year had an odds ratio (OR) and a 95% confidence interval (CI) of carotid atherosclerosis of 2.61 and 0.98-6.90 compared to those in the highest two tertiles of PMI with a CAE=0 mg/L-year. We conclude that individuals with greater exposure to arsenic and lower capacity to methylate inorganic arsenic may be at a higher risk to carotid atherosclerosis.
台湾黑脚病（BFD）高流行地区，长期饮用自流井饮用水中的无机砷与颈动脉粥样硬化有关。本研究检测了砷甲基化能力及其对颈动脉粥样硬化的风险。共纳入304名居住在BFD高流行地区的成年人（158名男性和146名女性）。通过双功超声评估颈动脉粥样硬化程度。通过累积砷暴露指数（CAE）和自流井水饮用时长估算慢性砷暴露。采用高效液相色谱-氢化物发生-原子吸收光谱法（HPLC-HG-AAS）测定尿中无机亚砷酸盐[As(III)]、砷酸盐[As(V)]、一甲基砷酸[MMA(V)]和二甲基砷酸[DMA(V)]水平。计算砷形态百分比、初级甲基化指数[PMI = MMA(V)/(As(III)+As(V)]和次级甲基化指数[SMI = DMA(V)/MMA(V)]，并将其作为砷甲基化能力指标。结果显示，女性和年轻受试者的砷甲基化能力比男性和老年人更强。与对照组相比，颈动脉粥样硬化患者的MMA(V)百分比[％MMA(V)]显著更高，而DMA百分比[％DMA(V)]更低。CAE中位数>0 mg/L-年的PMI最高两个三分位数的受试者，与CAE = 0 mg/L-年的PMI最高两个三分位数的受试者相比，颈动脉粥样硬化的比值比（OR）和95％置信区间（CI）分别为2.61和0.98-6.90。我们得出结论，砷暴露量较高且无机砷甲基化能力较低的个体患颈动脉粥样硬化的风险可能更高。
