Evaluation of the association between arsenic and diabetes: a National Toxicology Program workshop review.
Diabetes affects an estimated 346 million persons globally, and total deaths from diabetes are projected to increase > 50% in the next decade. Understanding the role of environmental chemicals in the development or progression of diabetes is an emerging issue in environmental health. In 2011, the National Toxicology Program (NTP) organized a workshop to assess the literature for evidence of associations between certain chemicals, including inorganic arsenic, and diabetes and/or obesity to help develop a focused research agenda. This review is derived from discussions at that workshop.



Our objectives were to assess the consistency, strength/weaknesses, and biological plausibility of findings in the scientific literature regarding arsenic and diabetes and to identify data gaps and areas for future evaluation or research. The extent of the existing literature was insufficient to consider obesity as an outcome.



Studies related to arsenic and diabetes or obesity were identified through PubMed and supplemented with relevant studies identified by reviewing the reference lists in the primary literature or review articles.



Existing human data provide limited to sufficient support for an association between arsenic and diabetes in populations with relatively high exposure levels (≥ 150 µg arsenic/L in drinking water). The evidence is insufficient to conclude that arsenic is associated with diabetes in lower exposure (< 150 µg arsenic/L drinking water), although recent studies with better measures of outcome and exposure support an association. The animal literature as a whole was inconclusive; however, studies using better measures of diabetes-relevant end points support a link between arsenic and diabetes.
Biomolecular Screening Branch, Division of the National Toxicology Program, National Institute of Environmental Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, North Carolina, USA.
Elizabeth A
EA
Maull
Habibul
H
Ahsan
Joshua
J
Edwards
Matthew P
MP
Longnecker
Ana
A
Navas-Acien
Jingbo
J
Pi
Ellen K
EK
Silbergeld
Miroslav
M
Styblo
Chin-Hsiao
CH
Tseng
Kristina A
KA
Thayer
Dana
D
Loomis
D000818:Animals; D001151:Arsenic / Q000032:analysis / Q000633:toxicity*; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000453:epidemiology*; D060766:Drinking Water / Q000032:analysis*; D004781:Environmental Exposure; D006801:Humans; D051379:Mice; D009765:Obesity / Q000139:chemically induced / Q000453:epidemiology; D051381:Rats; D014874:Water Pollutants, Chemical / Q000032:analysis / Q000633:toxicity*
D060766:Drinking Water; D014874:Water Pollutants, Chemical; D001151:Arsenic