Article Text

Download PDFPDF
Association of inorganic arsenic exposure with type 2 diabetes mellitus: a meta-analysis
  1. Weijing Wang,
  2. Zhutian Xie,
  3. Yan Lin,
  4. Dongfeng Zhang
  1. Department of Epidemiology and Health Statistics, The Medical College of Qingdao University, Qingdao, Shandong, People's Republic of China
  1. Correspondence to Professor Dongfeng Zhang, Department of Epidemiology and Health Statistics, The Medical College of Qingdao University, 38 Dengzhou Road, Qingdao, Shandong 266021, People's Republic of China; zhangdf1961{at} or zhangdf1962{at}


Background The association of long-term effects of inorganic arsenic (iAs) exposure with type 2 diabetes mellitus (T2DM) risk remains controversial.

Methods A literature search was performed in PubMed, China National Knowledge Infrastructure and Web of Knowledge for relevant available articles published in English or Chinese from 1 January 1990 to 5 June 2013. Case-control, cohort or cross-sectional studies evaluating iAs and T2DM were included. The DerSimonian and Laird random effect model was adopted as the pooling method. Dose-response relationship was assessed by restricted cubic spline model and multivariate random-effect meta-regression.

Results Of the 569 articles identified through searching databases, 17 published articles with 2 243 745 participants for iAs in drinking water and 21 083 participants for total arsenic (tAs) in urine were included for this meta-analysis. The pooled relative risk with 95% CI of T2DM for the highest versus lowest category of iAs exposure level in drinking water was 1.75 (1.20 to 2.54). After removing three studies that had a strong effect on heterogeneity, the pooled relative risk was 1.23 (1.12 to 1.36). Dose–response analysis suggested T2DM risk increased by 13% (1.13 (1.00 to 1.27)) for every 100 µg/L increment of iAs in drinking water. Significant association of T2DM risk with tAs in urine was also found 1.28 (1.14 to 1.44).

Conclusions This meta-analysis indicates that long-term iAs exposure might be positively associated with T2DM risk.

  • Environmental epidemiology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles