Abstract

Arsenic is among the most critical environmental toxicants associated with many human disorders. However, its effect on type 2 diabetes mellitus (T2DM) is contradictory. This systematic review and dose-response meta-analysis aim to update information on the association between arsenic exposure and the risk of T2DM. The sample type (drinking water, urine, blood, and nails) conducted the subgroup analysis. Evaluation of the high vs. low arsenic concentrations showed a significant association between drinking water arsenic (OR: 1.58, 95 CI: 1.20-2.08) and urinary arsenic (OR: 1.37, 95 CI: 1.24-1.51) with the risk of T2DM. The linear dose-response meta-analysis showed that each 1 mug/L increase in levels of drinking water arsenic (OR: 1.01, 95 CI: 1.00-1.01) and urinary arsenic (OR: 1.01, 95 CI: 1.00-1.02) was associated with a 1 increased risk of T2DM. The non-linear dose-response analysis indicated that arsenic in urine was associated with the risk of T2DM ((Pnon-linearity)<0.001). However, this effect was not statistically significant for arsenic in drinking water ((Pnon-linearity)=0.941). Our findings suggest that blood arsenic was not significantly linked to the increased risk of T2DM in high vs. low (OR: 1.21, 95 CI: 0.85-1.71), linear (OR: 1.04, 95 CI: 0.99-1.09), and non-linear (P(non-linearity)=0.365) analysis. Also, nail arsenic was not associated with the risk of T2DM in this meta-analysis (OR: 1.33, 95 CI: 0.69-2.59). This updated dose-response meta-analysis indicated that arsenic exposure was significantly correlated with the risk of T2DM.