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Chin-Hsiao Tseng,^1,2 Tong-Yuan Tai,¹ Choon-Khim Chong,³ Ching-Ping Tseng,⁴ Mei-Shu Lai,⁵ Boniface J. Lin,¹ Hung-Yi Chiou,² Yu-Mei Hsueh,² Kuang-Hung Hsu,⁶ and Chien-Jen Chen⁷

¹Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
²Graduate Institute of Public Health, Taipei Medical College, Taipei, Taiwan
³Department of Rehabilitation, Chang Gung Memorial Hospital, and Chong's Physical Medicine and Rehabilitation Clinic, Taipei, Taiwan
⁴School of Medical Technology, Chang Gung University, Taoyuan, Taiwan
⁵Central Bureau of National Health Insurance, Taipei, Taiwan
⁶Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
⁷Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan

Abstract

Diabetes prevalence in arseniasis-hyperendemic villages in Taiwan has been reported to be significantly higher than in the general population. The aim of this cohort study was to further evaluate the association between ingested inorganic arsenic and the incidence of non-insulin-dependent diabetes mellitus in these villages. A total of 446 nondiabetic residents in these villages were followed biannually by oral glucose tolerance test. Diabetes is defined as a fasting plasma glucose level 7.8 mmol/L and/or a 2-hr post-load glucose level 11.1 mmol/L. During the follow-up period of 1499.5 person-years, 41 cases developed diabetes, showing an overall incidence of 27.4/1,000 person-years. The incidence of diabetes correlated with age, body mass index, and cumulative arsenic exposure. The multivariate-adjusted relative risks were 1.6, 2.3, and 2.1 for age 55 versus < 55 years, a body mass index 25 versus < 25 kg/m², and a cumulative arsenic exposure 17 versus < 17 mg/L-years, respectively. The incidence density ratios (95% confidence intervals) between the hyperendemic villages and the two nonendemic control townships were 3.6 (3.5-3.6) , 2.3 (1.1-4.9) , 4.3 (2.4-7.7) , and 5.5 (2.2-13.5) , respectively, for the age groups of 35-44, 45-54, 55-64, and 65-74 years. The findings are consistent with our previous cross-sectional observation that ingested inorganic arsenic is diabetogenic in human beings. Key words: diabetes mellitus, incidence, ingested arsenic, oral glucose tolerance test, water pollutant. Environ Health Perspect 108:847-851 (2000) . [Online 31 July 2000]

http://ehpnet1.niehs.nih.gov/docs/2000/108p847-851tseng/ abstract.html

Address correspondence to C-H. Tseng, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan. Telephone: 886-2-23970800 ext. 7247. Fax: 886-2-23711453. E-mail: ccktsh@ms6.hinet.net

This study was supported by grants from the National Science Council, Republic of China (NSC-86-2314-B-002-326 ; NSC-87-2314-B-002-245 ; NSC-88-2621-B-002-030 ; and NSC-89-2320-B-002-125) , and the Department of Health (DOH89-TD-1035 and DOH88-HR-503) , Executive Yuan, Taiwan.

Received 30 November 1999 ; accepted 2 May 2000.