Am J Epidemiol. 2013 Nov 15;178(10):1563-70. doi: 10.1093/aje/kwt195. Epub 2013 Sep 18.
Chronic exposure to high levels of arsenic in drinking water is associated with increased risk of type 2 diabetes mellitus (T2DM), but the association between lower levels of arsenic and T2DM is more controversial. Therefore, this study evaluated the association between low to moderate arsenic exposure and T2DM. In 2009-2011, we conducted a study of 957 Bangladeshi adults who participated in a case-control study of skin lesions in 2001-2003. The odds ratio of T2DM was evaluated in relationship to arsenic exposure measured in drinking water and in subjects' toenails (in 2001-2003) prior to the diagnosis of T2DM (in 2009-2011). Compared with those exposed to the lowest quartile of arsenic in water (≤ 1.7 µg/L), the adjusted odds ratio for T2DM was 1.92 (95% confidence interval (CI): 0.82, 4.35) for those in the second quartile, 3.07 (95% CI: 1.38, 6.85) for those in the third quartile, and 4.51 (95% CI: 2.01, 10.09) for those in the fourth quartile. The relative excess risk of T2DM was 4.78 for individuals who smoked and 8.93 for people who had a body mass index (weight (kg)/height (m)(2)) greater than 25. These findings suggest that exposure to modest levels of arsenic in drinking water was associated with increased risk of T2DM in Bangladesh. Being overweight or smoking was also associated with increased risk of T2DM.
长期暴露于饮用水中的高砷水平与 2 型糖尿病（T2DM）的风险增加有关，但低水平砷与 T2DM 之间的关联更具争议。因此，本研究评估了低至中度砷暴露与 T2DM 之间的关系。2009-2011 年，我们对 957 名孟加拉成年人进行了一项研究，他们参加了 2001-2003 年皮肤损伤的病例对照研究。在诊断为 T2DM（2009-2011 年）之前，我们评估了 T2DM 与饮用水和受试者趾甲中砷暴露（2001-2003 年）之间的关联。与暴露于水中砷最低四分位数（≤1.7μg/L）的人相比，水中砷第二四分位数（1.7-2.8μg/L）的 T2DM 调整比值比为 1.92（95%置信区间（CI）：0.82，4.35），第三四分位数（2.8-4.8μg/L）为 3.07（95%CI：1.38，6.85），第四四分位数（4.8-8.2μg/L）为 4.51（95%CI：2.01，10.09）。患有糖尿病的个体相对 T2DM 超额风险为 4.78，体重指数（体重（kg）/身高（m）（2））大于 25 的个体为 8.93。这些发现表明，孟加拉国饮用水中适度砷暴露与 T2DM 风险增加有关。超重或吸烟也与 T2DM 风险增加有关。
