Abstract
BACKGROUND: Animal studies indicate that chronic exposure to certain tin compounds induces pancreatic islet cell apoptosis and glucose intolerance. However, little is known about the health effects of environmental tin exposure in humans. Therefore, we evaluated the association of tin exposure with diabetes in a nationally representative sample of US adults. METHODS: We used data from a nationally representative population (n = 3371) in the National Health and Nutrition Examination Survey 2011-14. Diabetes (n = 605) was defined as self-reported physician's diagnosis, HbA1c ≥6.5%, fasting plasma glucose ≥126 mg/dL, or 2-h plasma glucose ≥200 mg/dL. Tin concentrations in urine samples were determined by inductively coupled plasma mass spectrometry. Logistic regression with sample weights was used to estimate the odds ratios (ORs) of diabetes and 95% confidence intervals (CIs). RESULTS: Urinary tin concentrations were higher in individuals with diabetes (weighted median 0.58 μg/L) than those without diabetes (0.39 μg/L). After adjustment for urinary creatinine and other diabetes risk factors, the OR of diabetes comparing the highest with lowest quartile of urinary tin concentrations was 1.6 (95% CI 1.0-2.6; P(trend) = 0.02). CONCLUSIONS: Environmental tin exposure was positively and significantly associated with diabetes in US adults.