ARSENIC IN DRINKING WATER AMD PREVALENCE OF HYPERTENSION AMONG CASES OF TYPE 2 DIABETES - DATA FROM ZRENJANIN MUNICIPALITY, SERBIA

摘要

Background:Arsenic is constantly present in drinking-water supply systems of Zrenjanin municipality across decades. It presents a great public health problem in Serbia, but its relationship with the occurrence of hypertension among persons with type 2 diabetes mellitus (T2DM) has not been studied previously. Aims: The aims of this study is to assess the prevalence of hypertension among persons with type 2 diabetes in Zrenjanin municipality, consuming different levels of arsenic in drinking water, and to explore whether arsenic exposure increases risk for earlier onset of hypertension. Methods: This cross-sectional study included 281 cases of type 2 diabetes from Zrenjanin municipality, who were divided in two groups according to arsenic level in drinking water, based on current guidelines (10 μg/L). T2DM was diagnosed according to International Diabetes Federation (IDF) criteria, while hypertension was assessed according to the Seventh Joint National Criteria for Hypertension Classification (JNC7). Results: Prevalence of hypertension among persons with type 2 diabetes, who were exposed to drinking-water arsenic above 10 μg/L was 85.4%, and wassignificantly higher than the prevalence of hypertension among persons exposed to drinking-water arsenic below 10 μg/L (79.8%) (p＜0.05). An earlier onset of hypertension was observed among diabetic patients exposed to drinking water arsenic above 10 μg/L (average age 52.26±11.21) than in petients consuming arsenic less than 10 μg/L (55.83+11.28) (p＜0.05). Multivariate logistic regression analysis showed that age, obesity, waste-to-hip ratio and arsenic exposure above 10μg/L were significant risk factors for the development of hypertension in persons with T2DM. Conclusion: Arsenic exposure from drinking water, in concentrations above national standard, may increase the risk for the occurrence of hypertension and its earlier onset among persons with type 2 diabetes in Zrenjanin municipality.