Department of Environmental and Occupational Health, School of Public Health, China Medical University, No. 92 Bei Er Road, Heping District, Shenyang, Liaoning Province, 110001, China.
Environ Sci Pollut Res Int. 2013 Nov;20(11):8151-61. doi: 10.1007/s11356-013-1768-9. Epub 2013 May 7.
Prolonged exposure to inorganic arsenic has been a severe environmental public health issue worldwide in the recent decades. Increasing evidence has suggested a possible role of prolonged arsenic exposure through drinking water in the development of arsenic-induced chronic noncancer diseases, among which hypertension and type 2 diabetes (T2D) are the focus of concern. Although exposure to high levels of arsenic has been reported to be associated with excess risk of hypertension or T2D in a dose-dependent manner, the association has yet to be established, especially low-level exposure. This cross-sectional study was designed to evaluate the potential association between prolonged environmental arsenic exposure through drinking water and the prevalence of hypertension and T2D in Inner Mongolia, China, with emphasis on the assessment of low-level exposure. In this study (a total of 669 men and women), we found that the blood pressure levels were significantly correlated with cumulative arsenic exposure and that the systolic blood pressure of the subjects with arsenic exposure>50 μg/L was significantly higher than those of the subjects with <10 and 10-50 μg/L exposure. Significant prevalence of hypertension was found in the subjects of the >50 μg/L group both before and after adjustment for confounders. In addition, a significant negative relationship was found between urinary arsenic percentage of dimethylated arsenic (DMA%) and the prevalence of hypertension in the >50 μg/L group. However, low-level arsenic exposure (10-50 μg/L) was not statistically associated with hypertension. No significant difference of blood glucose was found among the groups with different arsenic exposure levels. No statistical association was found between arsenic exposure and T2D. Our findings suggested that prolonged arsenic exposure might play a role in the development of hypertension; however, only high-level arsenic was associated with the risk of hypertension. Our findings also indicated that lower DMA% might be related with the increased susceptibility of arsenic-induced hypertension.
几十年来，长期暴露于无机砷已成为全球严重的环境公共卫生问题。越来越多的证据表明，通过饮用水长期暴露于砷可能在砷诱导的慢性非癌症疾病的发展中起作用，其中高血压和 2 型糖尿病（T2D）是关注的焦点。尽管已经报道了高水平的砷暴露与高血压或 T2D 的超额风险呈剂量依赖性相关，但这种关联尚未建立，特别是在低水平暴露的情况下。本横断面研究旨在评估内蒙古地区通过饮用水长期暴露于环境砷与高血压和 T2D 患病率之间的潜在关联，重点评估低水平暴露。在这项研究中（共有 669 名男性和女性），我们发现血压水平与累积砷暴露显著相关，暴露于砷>50μg/L 的受试者的收缩压明显高于暴露于<10μg/L 和 10-50μg/L 的受试者。在调整混杂因素后，>50μg/L 组的受试者中发现了显著的高血压患病率。此外，在>50μg/L 组中，尿砷中二甲基砷（DMA%）的百分比与高血压的患病率之间存在显著的负相关关系。然而，低水平的砷暴露（10-50μg/L）与高血压无统计学关联。不同砷暴露水平组之间的血糖无显著差异。砷暴露与 T2D 之间未发现统计学关联。我们的研究结果表明，长期砷暴露可能在高血压的发展中起作用；然而，只有高水平的砷与高血压的风险相关。我们的研究结果还表明，较低的 DMA%可能与砷诱导的高血压易感性增加有关。
