Project Details
Description
PROJECT SUMMARY/ABSTRACT
In the United States (US), diabetes mellitus affects an estimated 34.2 million people, representing 10.5% of the
population, with 90-95% of diabetes cases characterized as type 2 diabetes mellitus (T2DM). Diabetes
prevalence has increased over time, with disparities by race/ethnicity. A review endorsed by the American
Diabetes Association recently identified exposure from toxic metals/metalloids, such as arsenic (As), as a risk
factor for T2DM. Less is known regarding the role of uranium (U). Drinking water represents a major source of
inorganic As and U exposure in the US, for both users of unregulated private wells and of regulated public
water. A current gap in knowledge is the contribution of drinking water to total As and U exposure, as
determined in urine, in general US populations, and whether drinking water As and U exposures are
associated with T2DM risk nationwide. Our objective is to examine the association of drinking water As and U
exposures with a) urinary metal/metalloid concentrations, and b) T2DM incidence and prevalence. Evaluating
drinking water metals/metalloids and T2DM can directly inform drinking water regulations that currently do not
consider T2DM as a health endpoint. Nationwide, analyses in diverse epidemiological populations are needed
to assess T2DM susceptibility across race/ethnicity and socioeconomic status groups, critical to understanding
and reducing health disparities. It is also important to assess whether the current public water Maximum
Contaminant Levels (MCLs) for As and U are adequately health protective. The association between water As
and U with their corresponding concentrations in urine in US populations has historically been difficult to
examine due to a lack of water composition data that could be linked to epidemiologic cohorts. Recently,
however, robust estimates of public water As and U and private well As data have been developed nationwide.
We will study three diverse epidemiologic cohorts in the US: the Multi-Ethnic Study of Atherosclerosis (MESA),
a prospective study of cardiovascular disease among diverse urban communities (incidence and prevalence);
the Strong Heart Family Study (SHS), a prospective study of cardiovascular disease among American Indian
communities (incidence and prevalence); and the National Health and Nutrition Examination Survey
(NHANES), a series of cross-sectional surveys representative of the general US population (prevalence). We
will evaluate the association of water As and U with T2DM risk by sex, race/ethnicity, age, SES, and by levels
of the other metal. We hypothesize that the contribution of drinking water to urinary metal/metalloid
concentrations will decrease following the implementation of the As and U MCL change. This study will
highlight subpopulations at increased susceptibility of water As and U-associated T2DM, will identify regions
and communities where future interventions to reduce drinking water As exposures are needed, and will inform
future regulatory needs including T2DM as a potential health endpoint for drinking water As and U.
Status | Finished |
---|---|
Effective start/end date | 9/1/22 → 8/31/23 |
Funding
- National Institute of Environmental Health Sciences: US$33,649.00
ASJC Scopus Subject Areas
- Endocrinology, Diabetes and Metabolism
- Epidemiology
- Urology
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