Work

Comment on Menke et al. Metals in Urine and Diabetes in U.S. Adults. Diabetes 2016;65:164–171

Year: 2016

Type: letter

Abstract: It is with great interest that we noted the important work by Menke et al. (1) on the relationship between metal excretion and the incidence of type 2 diabetes. We would like to draw attention to the potential confounders when interpreting data by relying on urinary metal levels as a proxy for environmental exposure to examine potential associations with overt diabetes. Specifically, it has previously been shown that subtle changes in renal physiology as well as changes in insulin and glucose levels result in changes in renal excretion rates of cadmium and other metals (2-10). Therefore, changes in renal physiology that are known to develop early in the course of frank diabetes (11) may present a confounder when examining the association between overt diabetes and urinary metal excretion. For this reason, we believe that including prediabetes as an outcome variable in parallel with type 2 diabetes when examining potential associations between exposure to nonessential transition metals and dysglycemia is a sensible approach to overcome this limitation given the high rate of progression from prediabetes to overt diabetes. Using this approach, we previously reported a nonlinear association between prediabetes and urinary cadmium excretion in the National Health and Nutrition Examination Survey (NHANES) 2005-2010 data set (12).

Source: Diabetes

DOI: 10.2337/db16-0555

Authors: Winifred P. Wong, Amisha Wallia, Joshua R. Edwards, Malek El Muayed

Institutions: Northwestern University, Midwestern University

Language: English

Topic: Heavy Metal Exposure and Toxicity

Subfield: Health, Toxicology and Mutagenesis

Field: Environmental Science

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: bronze

Funder: National Institute of Environmental Health Sciences