Review Article

Association between Arsenic Exposure and Diabetes: A Meta-Analysis

Table 1

Characteristics of studies.

Study (reference)RouteCase definitionExposure indicatorCases/population

Bartoli et al.,
1998 [71]
IngestionDeath certificateLiving in exposure area3/488

Chen et al.,
2010 [22]
IngestionSelf-reportArsenic in drinking water 241/11319

Coronado-González et al., 2007 [13]IngestionFPG
Medical records
Arsenic in urine200/400

del Razo et al.,
2011 [18]
IngestionFPGArsenic in drinking water25/258

Enterline and
Marsh, 1982 [72]
InhalationDeath certificateSmelter workers versus general population12/1061

Ettinger et al.,
2009 [42]
IngestionOGTTArsenic in blood456

Huang et al.,
2014 [16]
IngestionFPG
HbA1c
Arsenic in drinking water  
Arsenic in urine  
Arsenic exposure skin signs
14/142

Islam et al.,
2012 [47]
IngestionFPG
Self-report
Arsenic in drinking water47/1004

James et al.,
2013 [40]
IngestionMedical records  
Self-report
Arsenic in drinking water141/548

Jensen and Hansen, 1998 [73]InhalationHbA1cExposed versus unexposed workers64

Jovanovic et al.,
2013 [17]
IngestionNational registry of diabetesArsenic in drinking water242/195190

Kim and Lee,
2011 [19]
IngestionFPG
Self-report
Arsenic in urine  
Women  
Men

79/891  
77/786

Kim et al.,
2013 [57]
IngestionMedical recordsArsenic in drinking water150/300

Lagerkvist and Zetterlund, 1994 [32]InhalationSelf-reportSmelter workers versus unexposed reference89

Lai et al.,
1994 [14]
IngestionMedical history
OGTT
Self-report
Arsenic in drinking water86/891

Lewis et al.,
1999 [51]
IngestionDeath certificateArsenic in drinking water  
Women  
Men

35/961  
20/1242

Lubin et al.,
2000 [74]
InhalationDeath certificateSmelter workers versus US general population54/5011

Mabuchi et al.,
1980 [34]
InhalationDeath certificatePesticide workers versus US general population  
Men  
Women

1/197  
1/43

Makris et al.,
2012 [21]
IngestionSelf-reportArsenic in drinking water 317

Meliker et al., 2007 [60]IngestionDeath certificateArsenic in drinking water  
Women  
Men

1612/38722  
1249/41282

Nabi et al.,
2005 [75]
IngestionSerum glucoseArsenic in drinking water24/235

Navas-Acien et al., 2008 [50]IngestionFPG
Self-report
Arsenic in urine93/788

Navas-Acien et al., 2009 [48]IngestionFPG
Self-report
Arsenic in urine62/1279

Rahman and Axelson, 1995 [37]IngestionDeath certificateSmelter workers versus unexposed 43/369

Mahfuzar Rahman et al., 1996 [38]InhalationDeath certificateGlassworkers versus unexposed  
Glassblowers  
Unspecified glassworkers
   
6/74  
25/135

Rahman et al.,
1998 [15]
IngestionOGTT
Glucosuria  
Self-report
Arsenic exposure skin signs18/1107

Rahman et al.,
1999 [76]
IngestionGlucosuriaArsenic in drinking water105/1481

Rhee et al.,
2013 [39]
IngestionFPG
Serum insulin
Arsenic in urine 309/3602

Ruiz-Navarro et al.,
1998 [52]
IngestionMedical recordsArsenic in urine38/126

Steinmaus et al.,
2009 [77]
IngestionFPG
Self-report
Arsenic in urine795

Tollestrup et al.,
2003 [78]
IngestionDeath certificateLiving in exposure area  
Men  
Women

3/162  
1/110

Tsai et al.,
1999 [56]
IngestionDeath certificateArsenic in drinking water  
Men  
Women

188/11193  
343/8874

Tseng et al.,
2000 [44]
IngestionFPG
OGTT
Arsenic in drinking water41/446

Wang et al.,
2003 [59]
IngestionMedical recordsArsenic in drinking water5998/706314

Wang et al.,
2007 [53]
IngestionFPGArsenic in hair166/660

Wang et al.,
2009 [45]
IngestionMedical recordsArsenic in drinking water235

Ward and Pim,
1984 [79]
IngestionMedical recordsArsenic in plasma117

Zierold et al.,
2004 [46]
IngestionSelf-reportArsenic in drinking water1185

FPG: fasting plasma glucose; OGTT: oral glucose tolerance test; the diagnosis of DM is confirmed by laboratory tests or medical records.