Gender Differences in the Risk of Metabolic Syndrome Among Chronic Arsenic-Exposed Individuals in Bangladesh

Arsenic is a ubiquitous environmental contaminant that causes cardiovascular diseases (CVDs) and diabetes. Metabolic syndrome (MeS) is a cluster of conditions associated with the future risk of CVDs and diabetes. Although CVDs are the major causes of arsenic-related mortality, the association between arsenic exposure and MeS remains elusive. Recently, we have reported that arsenic exposure increases hyperglycemia and insulin resistance with greater susceptibility in females than in males. Therefore, we explored the associations of arsenic exposure with the risk of MeS and its components focusing on gender differences. MeS was defined by the modified NCEP ATP III guidelines. A total of 569 adults were recruited from high- and low-arsenic-exposure areas in Bangladesh. Arsenic concentrations in drinking water, hair, and nails were determined as exposure markers. Among 569 subjects, 156 were found to have MeS. Levels of arsenic and the components of MeS were significantly higher in MeS group than those in non-MeS group. Prevalence and odds ratios (ORs) of MeS were increased with increasing exposure to arsenic showing more precise dose-dependent association in women than in men. Except hypertriglyceridemia, the changes in ORs for other components of MeS such as hyperglycemia, hypo-high-density lipoprotein-cholesterolemia, hyper-systolic blood pressure, and abdominal obesity with arsenic exposure were more pronounced in women than in men. Thus, the higher risk of arsenic-related MeS in women than in men suggests a greater susceptibility of women to CVDs that warrant more future investigations on the gender-based distinct pathophysiologic mechanisms of arsenic-related CVDs and diabetes.