Carcinogenesis, Teratogenesis & Mutagenesis ›› 2020, Vol. 32 ›› Issue (2): 87-91,97.doi: 10.3969/j.issn.1004-616x.2020.02.002

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Relationships between urine arsenic levels and hemoglobin A1C in type 2 diabetic patients exposed to arsenic

XIAO Chen1, WENG Fan2, LIU Jieyi1, XIAO Baixiang3, WANG Xiaohui1, LIU Huaixiang1, XIE Yirong1, ZHAO Zhiqiang1, HE Yun1   

  1. 1. Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou 510080;
    2. Yuexiu Center for Disease Control and Prevention, Guangzhou 510120;
    3. Department of Preventive Ophthalmology Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong, China
  • Received:2020-01-09 Revised:2020-02-20 Online:2020-03-30 Published:2020-04-10

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Abstract: OBJECTIVE: To explore the relationships between urine arsenic levels and hemoglobin A1C(HbA1C) in type 2 diabetic mellitus (T2DM) patients who were exposed to low levels of arsenic. METHODS: A case-series study involving 401 patients with T2DM and with exposure to arsenic in a district of Guangzhou were selected as the study subjects in 2018. The basic data of patients were obtained by questionnaire and physical examination,and the biological samples (the blood and urine samples) of patients were collected to detect blood glucose,blood lipid,HbA1C and urine arsenic. According to the levels of arsenic in urine,the patients were divided into three groups. t-test,χ2 test and analysis of variance (ANOVA) were used to compare the differences of indicators such as blood glucose,blood lipid,HbA1C and urine arsenic among the groups. Multivariate logistic regression analyses were conducted to evaluate the influencing factors of HbA1C in patients with T2DM. RESULTS: A total of 401 patients exposed to low-dose arsenic were included. The median of urine arsenic was 38.31 μg/L,and the interquartile range was 48.25 μg/L. There was a linear increasing trend of HbA1C with changes of urine arsenic in different urine arsenic level groups,and the difference between the high and the low level groups was statistically significant (P < 0.05). With the increase of urine arsenic levels between the groups,the number of normal control group (HbA1C < 7.0%) decreased gradually,the number of abnormal control group (HbA1C ≥ 7.0%) increased gradually,the difference was statistically significant (P < 0.05). Multivariate regression analyses show that urine arsenic was the influencing factor of HbA1C,OR(95%CI) of the high arsenic group was 2.077 (1.049,4.110),the difference of HbA1C between the high and the low level groups was statistically significant (P < 0.05). CONCLUSION: Urine arsenic is related to the level of HbA1C in patients with T2DM,which may be the influencing factor of HbA1C,and its mechanism needs to be further explored.

Key words: low level arsenic exposure, urine arsenic, hemoglobin A1C, type 2 diabetes mellitus, regression analysis

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