Urinary Metals and Incident Diabetes in Midlife Women: Study of Women’s Health Across the Nation (SWAN)

Details

• Personal Author:
  Harlow SD ; Herman WH ; Karvonen-Gutierrez CA ; Mukherjee B ; Park SK ; Wang X
• Description:
  Introduction: Environmental exposure to metals may play a role in the pathogenesis of diabetes; however, evidence from human studies is limited. We prospectively evaluated the associations of 20 urinary metal concentrations and their mixtures with incident diabetes in the Study of Women's Health Across the Nation, a multisite, multiethnic cohort study of midlife women. Research design and methods: The sample included 1237 white, black, Chinese and Japanese-American women, aged 45-56 years, free of diabetes at baseline (1999-2000) who were followed through 2016. Concentrations of 20 metals (arsenic, barium, beryllium, cadmium, cobalt, chromium, cesium, copper, mercury, manganese, molybdenum, nickel, lead, antimony, tin, thallium, uranium, vanadium, tungsten and zinc) were measured in urine specimens at baseline. Incident diabetes was identified annually by fasting glucose >/=126 mg/dL, self-reported doctor-diagnosed diabetes, or self-reported use of antidiabetic medications. A non-parametric clustering method, k-means clustering, was used to identify subgroups with different exposure patterns to metal mixtures. Results: After multivariable adjustment, the HR (95% CI) for diabetes associated with each doubling increase in urinary metal concentrations was 1.19 (1.10 to 1.30) for arsenic and 1.20 (1.05 to 1.37) for lead, in Cox proportional hazards models after controlling for multiple comparisons. A doubling in urinary excretion of zinc was associated with higher risk of diabetes (adjusted HR 1.31, 95% CI 1.11 to 1.53). Two distinct exposure patterns to metal mixtures-'high' versus 'low'-were identified. Participants assigned to the 'high' pattern had higher overall concentrations of all metals compared with those classified into the 'low' pattern. Adjusted HR for diabetes associated with 'high' pattern compared with 'low' was 1.42 (1.08 to 1.87). Conclusions: Higher urinary concentrations of arsenic and lead, increased urinary excretion of zinc, as well as higher overall exposure to metal mixtures were associated with elevated risk of diabetes. Future studies should further investigate the underlying mechanisms. [Description provided by NIOSH]
• Subjects:
  Age Factors Blood Cohort Studies Environmental Exposure Hematologic Diseases Metals Occupational Health Safety Women
• Keywords:
  Age Factors Biomonitoring Blood Sugar Disorders Cohort Studies Environmental Exposure Exposure Levels Longitudinal Study Metallic Compounds
• ISSN:
  2052-4897
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Michigan ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  8
• Issue:
  1
• NIOSHTIC Number:
  nn:20061522
• Citation:
  BMJ Open Diabetes Res Care 2020 Jul; 8(1):e001233
• Contact Point Address:
  Dr. Sung Kyun Park, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
• Email:
  sungkyun@umich.edu
• CAS Registry Number:
  Lead (CAS RN 7439-92-1) ; Zinc (CAS RN 7440-66-6)
• Federal Fiscal Year:
  2020
• Performing Organization:
  University of Michigan, Ann Arbor
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  BMJ Open Diabetes Research & Care
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:722a9be8dae414f9335da2f267d0911431bea9e5c8cd04ed969714af59c4b1c3c6c3566560815bd6999cea5b7f4c4874bd3be132cb4922547bfb5474d11c8540
• Download URL:
  https://stacks.cdc.gov/view/cdc/225036/cdc_225036_DS1.pdf
• File Type:
  [PDF - 446.69 KB ]