Association of water arsenic and uranium exposures with incident diabetes in Indigenous US communities: The Strong Heart Study
Year: 2023
Type: conference-abstract
Abstract: BACKGROUND AND AIM: In the United States (US), type 2 diabetes (T2D) affects approximately 37.3 million people (11.3% of the population), with the highest burden in American Indian communities. Toxic metal exposures have been identified as risk factors of T2D. Most studies rely on biomarkers, which could be affected by early disease processes. Studies directly measuring metals in drinking water in US populations have been limited. We examined the association of arsenic and uranium exposures in community water systems (CWS) and private wells with T2D incidence in American Indian communities to address current limitations in direct associations between metal exposures and T2D. METHOD: We evaluated adults in the Strong Heart Family Study (SHFS) free of T2D at baseline (2001-2004) and followed through 2010, with available water arsenic (N=1,737) and uranium (N=1,559) estimates assigned by residential zip code. We used mixed effects Cox models to account for clustering by family and residential zip code, modeling the association between log-transformed arsenic and uranium per linear and non-linear (restricted cubic splines) interquartile range (IQR) change and the risk of T2D. We also assessed cross-sectional associations between water arsenic and uranium levels and prevalent prediabetes at baseline. RESULTS: T2D incidence in the SHFS was 13.5% (mean follow-up 5.6 years). After adjustment for sex, education, smoking status, body mass index, and estimated glomerular filtration rate, the hazard ratio (95% CI) of incident diabetes excluding prediabetes was 1.06 (1.02, 1.10) and 1.30 (0.79, 2.14) comparing 75th vs. 25th percentiles of private well and CWS arsenic, respectively. Public water and private well uranium were not associated with incident T2D, however private well uranium was associated with prevalent prediabetes (odds ratio = 1.28 (1.02, 1.59)). CONCLUSIONS: Water arsenic levels were associated with T2D incidence and prediabetes prevalence. Water uranium was associated with pre-diabetes but not with incident diabetes.
Source: ISEE Conference Abstracts
Language: English
Subfield: Environmental Chemistry
Field: Environmental Science
Domain: Physical Sciences
Open Access status: diamond
OpenAlex ID: W4390965085