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Cited by 339Arsenic contamination and mitigationHeavy Metal Exposure and ToxicityHealth, Environment, Cognitive Aging

Arsenic Exposure and Type 2 Diabetes: A Systematic Review of the Experimental and Epidemiologic Evidence

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Navas-Acien, Ana, Silbergeld, Ellen K., Streeter, Robin A., Clark, Jeanne M., Burke, Thomas A., Guallar, Eliseo·2006·Environmental Health Perspectives
DOI 10.1289/ehp.8551PMC PMC1459913
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Abstract

Chronic arsenic exposure has been suggested to contribute to diabetes development. We performed a systematic review of the experimental and epidemiologic evidence on the association of arsenic and type 2 diabetes. We identified 19 in vitro studies of arsenic and glucose metabolism. Five studies reported that arsenic interfered with transcription factors involved in insulin-related gene expression: upstream factor 1 in pancreatic β-cells and peroxisome proliferative-activated receptor γ in preadipocytes. Other in vitro studies assessed the effect of arsenic on glucose uptake, typically using very high concentrations of arsenite or arsenate. These studies provide limited insight on potential mechanisms. We identified 10 in vivo studies in animals. These studies showed inconsistent effects of arsenic on glucose metabolism. Finally, we identified 19 epidemiologic studies (6 in high-arsenic areas in Taiwan and Bangladesh, 9 in occupational populations, and 4 in other populations). In studies from Taiwan and Bangladesh, the pooled relative risk estimate for diabetes comparing extreme arsenic exposure categories was 2.52 (95% confidence interval, 1.69–3.75), although methodologic problems limit the interpretation of the association. The evidence from occupational studies and from general populations other than Taiwan or Bangladesh was inconsistent. In summary, the current available evidence is inadequate to establish a causal role of arsenic in diabetes. Because arsenic exposure is widespread and diabetes prevalence is reaching epidemic proportions, experimental studies using arsenic concentrations relevant to human exposure and prospective epidemiologic studies measuring arsenic biomarkers and appropriately assessing diabetes should be a research priority.

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  • Trivalent arsenicals (AsIII, MMAIII, and DMAIII) can induce diabetes via distortion of glucose metabolism based on intact pancreatic islets from mice.

    “Researchers have pointed out that trivalent arsenicals (AsIII, MMAIII, and DMAIII) can induce diabetes via distortion of glucose metabolism based on intact pancreatic islets from mice [75, 76].”

    From Arsenic Contamination of Groundwater: A Review of Sources, Prevalence, Health Risks, and Strategies for Mitigation (2014) · cites this paper as [75]

    The Results (In Vitro Experimental Studies; page not provided) report that arsenite and a trivalent methylated arsenical affected insulin-stimulated glucose uptake in cultured cells. They do not report this finding for DMAIII or for intact pancreatic islets from mice, and the Discussion says the relevance of these in vitro findings to diabetes development is uncertain. (LLM, conf=0.86)

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Authors
Navas-Acien, A., Silbergeld, E. K., Streeter, R. A., Clark, J. M., Burke, T. A., & Guallar, E.
Affiliations
  • Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health,
  • Johns Hopkins University (US)
ORCID
Venue
Environmental Health Perspectives
Publisher
American Chemical Society (ACS)
Published
2005-12-15
Volume
114
Issue
5
Pages
641-648
ISSN
  • 0091-6765 (ISSN-L)
  • 1552-9924
DOI
10.1289/ehp.8551
PMC
PMC1459913
OpenAlex
W2081530642
Cited by
339
References
77
Citations by year
2026: 9 · 2025: 13 · 2024: 18 · 2023: 12 · 2022: 16 · 2021: 10 · 2020: 15 · 2019: 19 · 2018: 24 · 2017: 18 · 2016: 12 · 2015: 27 · 2014: 24 · 2013: 21 · 2012: 20
FWCI
1.46
Type
journal article
Language
en
Open access
Licence
Locations
  • Environmental Health Perspectives (publishedVersion, public-domain)
  • PubMed Central (publishedVersion, public-domain)
  • PubMed (publishedVersion)
Funders
  • Johns Hopkins University
  • Centers for Disease Control and Prevention
  • U.S. Public Health Service (U50CCU322417)
  • National Institute of Environmental Health Sciences (R01ES012673)
Topics
  • Physical Sciences › Environmental Science › Environmental Chemistry › Arsenic contamination and mitigation
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Heavy Metal Exposure and Toxicity
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Health, Environment, Cognitive Aging
Keywords
arsenic exposure, type 2 diabetes, arsenic trioxide, arsenate, glucose metabolism, insulin signaling, transcription factors, pancreatic beta cells, PPARγ, occupational arsenic exposure, diabetes risk
MeSH terms
Air Pollutants, Arsenic, Bangladesh, Diabetes Mellitus, Type 2, Humans, Taiwan, Evidence-Based Medicine

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