title: Chronic Exposure to Arsenic and Markers of Cardiometabolic Risk: A Cross-Sectional Study in Chihuahua, Mexico.
abstract: BACKGROUND
  Exposure to arsenic (As) concentrations in drinking water > 150 μg/L has been associated with risk of diabetes and cardiovascular disease, but little is known about the effects of lower exposures.
  
  
  OBJECTIVE
  This study aimed to examine whether moderate As exposure, or indicators of individual As metabolism at these levels of exposure, are associated with cardiometabolic risk.
  
  
  METHODS
  We analyzed cross-sectional associations between arsenic exposure and multiple markers of cardiometabolic risk using drinking-water As measurements and urinary As species data obtained from 1,160 adults in Chihuahua, Mexico, who were recruited in 2008-2013. Fasting blood glucose and lipid levels, the results of an oral glucose tolerance test, and blood pressure were used to characterize cardiometabolic risk. Multivariable logistic, multinomial, and linear regression were used to assess associations between cardiometabolic outcomes and water As or the sum of inorganic and methylated As species in urine.
  
  
  RESULTS
  After multivariable adjustment, concentrations in the second quartile of water As (25.5 to < 47.9 μg/L) and concentrations of total speciated urinary As (< 55.8 μg/L) below the median were significantly associated with elevated triglycerides, high total cholesterol, and diabetes. However, moderate water and urinary As levels were also positively associated with HDL cholesterol. Associations between arsenic exposure and both dysglycemia and triglyceridemia were higher among individuals with higher proportions of dimethylarsenic in urine.
  
  
  CONCLUSIONS
  Moderate exposure to As may increase cardiometabolic risk, particularly in individuals with high proportions of urinary dimethylarsenic. In this cohort, As exposure was associated with several markers of increased cardiometabolic risk (diabetes, triglyceridemia, and cholesterolemia), but exposure was also associated with higher rather than lower HDL cholesterol.
  
  
  BACKGROUND
  Mendez MA, González-Horta C, Sánchez-Ramírez B, Ballinas-Casarrubias L, Hernández Cerón R, Viniegra Morales D, Baeza Terrazas FA, Ishida MC, Gutiérrez-Torres DS, Saunders RJ, Drobná Z, Fry RC, Buse JB, Loomis D, García-Vargas GG, Del Razo LM, Stýblo M. 2016. Chronic exposure to arsenic and markers of cardiometabolic risk: a cross-sectional study in Chihuahua, Mexico. Environ Health Perspect 124:104-111; http://dx.doi.org/10.1289/ehp.1408742.
authors.affiliation: Department of Nutrition, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Mendez
authors.forename: Carmen
authors.initials: C
authors.lastname: González-Horta
authors.forename: Blanca
authors.initials: B
authors.lastname: Sánchez-Ramírez
authors.forename: Lourdes
authors.initials: L
authors.lastname: Ballinas-Casarrubias
authors.forename: Roberto Hernández
authors.initials: RH
authors.lastname: Cerón
authors.forename: Damián Viniegra
authors.initials: DV
authors.lastname: Morales
authors.forename: Francisco A Baeza
authors.initials: FA
authors.lastname: Terrazas
authors.forename: María C
authors.initials: MC
authors.lastname: Ishida
authors.forename: Daniela S
authors.initials: DS
authors.lastname: Gutiérrez-Torres
authors.forename: R Jesse
authors.initials: RJ
authors.lastname: Saunders
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Drobná
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Fry
authors.forename: John B
authors.initials: JB
authors.lastname: Buse
authors.forename: Dana
authors.initials: D
authors.lastname: Loomis
authors.forename: Gonzalo G
authors.initials: GG
authors.lastname: García-Vargas
authors.forename: Luz M
authors.initials: LM
authors.lastname: Del Razo
authors.forename: Miroslav
authors.initials: M
authors.lastname: Stýblo
mesh_terms: D000328:Adult; D001151:Arsenic / Q000633:toxicity*; D002318:Cardiovascular Diseases / Q000097:blood*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008800:Mexico; D008875:Middle Aged; D014874:Water Pollutants, Chemical / Q000633:toxicity
chemical_list: D014874:Water Pollutants, Chemical; D001151:Arsenic