Lai M S, Hsueh Y M, Chen C J, Shyu M P, Chen S Y, Kuo T L, Wu M M, Tai T Y
Department of Family Medicine, National Taiwan University College of Medicine, Taipei, Republic of China.
Am J Epidemiol. 1994 Mar 1;139(5):484-92. doi: 10.1093/oxfordjournals.aje.a117031.
To examine the association between ingested inorganic arsenic and prevalence of diabetes mellitus, in 1988, the authors studied 891 adults residing in villages in southern Taiwan where arseniasis is hyperendemic. The status of diabetes mellitus was determined by an oral glucose tolerance test and a history of diabetes regularly treated with sulfonylurea or insulin. The cumulative arsenic exposure in parts per million-years was calculated from the detailed history of residential addresses and duration of drinking artesian well water obtained through standardized interviews based on a structured questionnaire and the arsenic concentration in well water. The body mass index was derived from body height and weight measured according to a standard protocol, while the physical activity at work was also obtained by questionnaire interviews. Residents in villages where the chronic arseniasis was hyperendemic had a twofold increase in age- and sex-adjusted prevalence of diabetes mellitus compared with residents in Taipei City and the Taiwan area. There was a dose-response relation between cumulative arsenic exposure and prevalence of diabetes mellitus. The relation remained significant after adjustment for age, sex, body mass index, and activity level at work by a multiple logistic regression analysis giving a multivariate-adjusted odds ratio of 6.61 and 10.05, respectively, for those who had a cumulative arsenic exposure of 0.1-15.0 and greater than 15.0 ppm-year compared with those who were unexposed. These results suggest the chronic arsenic exposure may induce diabetes mellitus in humans.
为研究摄入的无机砷与糖尿病患病率之间的关联，作者于1988年对居住在台湾南部砷中毒高度流行村庄的891名成年人进行了研究。糖尿病状况通过口服葡萄糖耐量试验以及有规律地接受磺脲类药物或胰岛素治疗的糖尿病病史来确定。百万分率 - 年的累积砷暴露量是根据通过基于结构化问卷的标准化访谈获得的详细居住地址历史和饮用自流井水的持续时间以及井水中的砷浓度计算得出的。体重指数由按照标准方案测量的身高和体重得出，而工作中的体力活动情况也通过问卷调查获得。与台北市和台湾地区的居民相比，慢性砷中毒高度流行村庄的居民经年龄和性别调整后的糖尿病患病率增加了两倍。累积砷暴露与糖尿病患病率之间存在剂量 - 反应关系。在通过多因素逻辑回归分析对年龄、性别、体重指数和工作活动水平进行调整后，这种关系仍然显著，与未暴露者相比，累积砷暴露量为0.1 - 15.0和大于15.0 ppm - 年的人群的多因素调整比值比分别为6.61和10.05。这些结果表明，慢性砷暴露可能会诱发人类患糖尿病。
