Table 3.
Epidemiological studies of arsenic exposure and β2MG, NAG, RBP, and A1M outcomes5
| Reference and Country | Population | Study Design | N | Outcome Ascertainment | Arsenic Assessment | Exposure Levels | Effect Estimate (95 % CI) | Adjustment Factors |
|---|---|---|---|---|---|---|---|---|
| High arsenic levels in drinking water (> 100 μg/L) | ||||||||
|
Hong et al. 2003 Southern China |
Occupational ≥ 25 years 75.6 % men |
Cross- sectional | 147 (114 workers, 33 unexposed) | Urine albumin, β2MG, NAG levels | Urine (AAS) | Urine As (μg/g) 0–49 50–99 100–199 ≥ 200 |
Urine B2MG (μg/g) 107.2 204.2 309.1 398.1 NAG (U/g) 11.2 21.4 27.5 33.1 p value < 0.01 |
None |
|
Nordberg et al. 2005 Hong et al. 2004 Guizhou China6 |
Adults NR 59.5 % men |
Cross- sectional | 245 | β2M > 0.30mg/g RBP > 0.3 mg/g, NAG > 23U/g |
Urine (GFAA) | High As area mean (range) 288.4 (33.3–1,973.0) μg/g Control Area 56.23 (12.41–476.54) μg/g |
Geometric mean 0.163 for RBP and 0.344 for β2M if UCD > 4.8 μg/g cr and As > 36 but only for women (also, see Buchet et al. 2003) |
Age, sex (matched) |
|
Wang et al. 2009 Xinjiang, China |
General (High water As area of China) 44.3 % men, All subjects > 30 years old |
Cross- sectional | 235 | Urine NAG levels | Urine (ICPMS) | Control areas: Urine As (μg/g), mean(SD) 208.6 (231.6) 16–38 μg/l water Endemic area: 20–272 μg/l water Urine As (μg/g), mean(SD) 270.6 (395.3) |
NAG: Geometric mean in control area: 10.29 Endemic area: 12.18 |
None |
|
Chen et al. 2011 Changhua,Taiwan |
High As area with industrial exposure Mean age 25.0 years 46.8 % men |
Cross- sectional | 1,043 | Renal dysfunction defined by β2MG > 0.154 mg/L | Urine (ICPMS) | Urine As μg/g ≤ 35 35–75 75–200 > 200 |
Renal dysfunction defined by β2MG: 1.00 (Reference) 1.69 (0.94–3.64) 2.11 (1.23–4.98) 2.04 (1.11–4.37) |
Age, sex, smoking, diabetes, hypertension, lead, cadmium, nickel, living area, |
| Low to moderate arsenic levels in drinking water (<100 μg/L) | ||||||||
|
Buchet et al 2003 Belgium7 |
Areas with smelters, Mean age 48.1 years 35.6 % men |
Cross- sectional | 568 | 24-hour urine β2M, NAG, RBP, and albumin | 24-h urine Hydride generation atomic absorption | Most below 25 μg/g | r = 0.16 with RBP (p < 0.05) NS with β2M, NAG, and albumin |
Hypertension, painkillers, blood cadmium*diabetes, diabetes, GGT, blood cadmium*hypertension |
|
Karmaus et al. 2008 Bulgaria |
Adults 48.9 % men ≥ 30 years 48.7 % men |
Cross- sectional | 201 baseline 189 follow-up |
Urine β2MG, | Urine (GFAA) | Median (5th, 95th percentile) 3.10 (0.70, 9.30) μg/L in 2003–2004 2.90 (0.80, 8.90) μg/L in 2004–2005 |
Mean difference in β2MG per unit increase As: 0.001 (p value=NS) | Age, sex, smoking, diabetes, hypertension, pyelonephritis, kidney stones, creatinine, blood lead, serum selenium, urine cadmium |
|
Halatek et al 2009 Poland |
Occupational Mean age 43.5 years 100 % men |
Cross- sectional | 55 39 exposed, 16 unexposed |
Urine β2MG and RBP | Urine (ICPMS) | Mean (SD) urine As in control 19.6 (19.9) μg/l Mean urine As in exposed: 43.3 (54.1) μg/l |
Spearman correlations As vs. RBP 0.43 (p value=0.01) As vs.β2M 0.32 (p value=0.05) Among exposure participants |
None |
|
Huang et al. 2009 South Korea |
Korean adults 93.4 % of participants > 40 years 29.7 % male |
Cross- sectional | 290 | Urine β2MG, NAG | Urine (GFAA) | Overall geometric mean (SD) of 5.70 (2.19) μg/L or 3.95 (1.73) μg/g | Pearson correlation As(μg/L) vs. β2MG 0.004 (p value=NS) As(μg/L)vs. NAG 0.300 (p value<0.05) As (μg /g cr) vs. β2MG 0.06 (p value=NS) As (μg /g cr) vs. NAG 0.09 (p value=NS) |
None |
|
Eom et al. 2011 Chungbuk, South Korea |
Area of high mine density, Age ≥ 20 years 43.6 % men |
Cross- sectional | 815 | Urine NAG concentration levels | Urine Hydride generation AAS | Geometric mean (SD) of 8.47 (1.89) μg/g creatinine Urine As as continuous variable | Correlation between As and NAG Low NAG group without seafood consumption: 0.052 With seafood: −0.171 (p < 0.01) High NAG group, without seafood: 0.293 (p < 0.01), with seafood 0.114. |
None |
|
Robles-Osorio et al. 2012 Central México |
5 communities in Central Mexico Mean age 40.9 years 22.2 % men |
Cross- sectional | 90 (11 had CKD) | Urine A1M levels | Urine Hydride generation AA | Mean (range) of 15.0 (0.56–89.2) μg/g | Mean difference (β) in urine A1M per increase in As is −0.109 (p < 0.01) (other results NS) Medians urine As of CKD cases/noncases: 13.6 and 16.2 μg/g cr (NS) |
Age, BMI, SBP, GFR, uric acid, glucose |
5
β2MG β-2 microglobulin, NAG N-acetyl-β-D-glucosaminidase, RBP Retinol binding protein, A1M α-1-microglobulin
6
The Zhejiang population was excluded because it was a coastal area with high seafood consumption
7
The Chinese cohort was excluded because it was the same cohort as Nordberg et al. 2005