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Associations between Arsenic Species in Exfoliated Urothelial Cells and Prevalence of Diabetes among Residents of Chihuahua, Mexico


Currier, Jenna M.; Ishida, Maria C.; Gonzalez-Horta, Carmen; Sanchez-Ramirez, Blanca; Ballinas-Casarrubias, Lourdes; Gutierrez-Torres, Daniela S.; Hernandez Ceron, Roberto; Viniegra Morales, Damian; Baeza Terrazas, Francisco A.; & Del Razo, Luz M., et al. (2014). Associations between Arsenic Species in Exfoliated Urothelial Cells and Prevalence of Diabetes among Residents of Chihuahua, Mexico. Environmental Health Perspectives, 122(10), 1088-1094. PMCID: PMC4181927


BACKGROUND: A growing number of studies link chronic exposure to inorganic arsenic (iAs) with risk of diabetes. Many of these studies assessed iAs exposure by measuring arsenic (As) species in urine. However, this approach has been criticized because of uncertainties associated with renal function and urine dilution in diabetic individuals. OBJECTIVES: Our goal was to examine associations between prevalence of diabetes and concentrations of As species in exfoliated urothelial cells (EUC) as an alternative to the measures of As in urine.
METHODS: We measured concentrations of trivalent and pentavalent iAs, methyl-As (MAs), and dimethyl-As (DMAs) species in EUC from 374 residents of Chihuahua, Mexico, who were exposed to iAs in drinking water. We used fasting plasma glucose, glucose tolerance tests, and self-reported diabetes diagnoses or medication to identify diabetic participants. Associations between As species in EUC and diabetes were estimated using logistic and linear regression adjusting for age, sex, and body mass index.
RESULTS: We found that interquartile range increases in trivalent, but not pentavalent As species in EUC were positively and significantly associated with diabetes, with OR of 1.57 (95% CI: 1.19, 2.07) for iAsIII, 1.63 (1.24 - 2.15) for MAsIII, and 1.31 (0.96 - 1.84) for DMAsIII. DMAs/MAs and DMAs/iAs ratios were negatively associated with diabetes (OR = 0.62; 95% CI: 0.47, 0.83 and OR = 0.72; 95% CI: 0.55, 0.96, respectively).
CONCLUSIONS: Our data suggest that uncertainties associated with measures of As species in urine may be avoided by using As species in EUC as markers of iAs exposure and metabolism, and provide additional support to previous findings suggesting that trivalent As species may be responsible for associations between diabetes and chronic iAs exposure.


Reference Type

Journal Article

Year Published


Journal Title

Environmental Health Perspectives


Currier, Jenna M.
Ishida, Maria C.
Gonzalez-Horta, Carmen
Sanchez-Ramirez, Blanca
Ballinas-Casarrubias, Lourdes
Gutierrez-Torres, Daniela S.
Hernandez Ceron, Roberto
Viniegra Morales, Damian
Baeza Terrazas, Francisco A.
Del Razo, Luz M.
Garcia-Vargas, Gonzalo G.
Saunders, R. Jesse
Drobna, Zuzana
Fry, Rebecca C.
Matousek, Tomas
Buse, John B.
Mendez, Michelle A.
Loomis, Dana P.
Styblo, Miroslav