Chronic arsenic exposure and cardiometabolic biomarkers in adolescents in the MINIMat longitudinal study

It is well-established that environmental factors, including pollutants, can increase cardiometabolic disease (CMD) risk in adults, but evidence regarding the influence already perceivable earlier in life is limited. In a longitudinal birth cohort, we have shown that early life arsenic exposure was associated with altered CMD biomarkers among young children. Herein, we assessed whether the association between arsenic exposure and CMD biomarkers persists at adolescent age. MINIMat adolescents (n = 460) who have been repeatedly followed-up from in utero to 4.5, and 9 years were enrolled at 15 years of age. Total urinary arsenic (U-As), blood pressure (BP), as well as plasma lipids [total cholesterol (TC), triglyceride (TG), low density lipoproteins (LDL), high-density lipoproteins (HDL)], oxidized LDL, glucose, and blood hemoglobin A1c (HbA1c) were measured. Associations were explored using multivariate and logistic regression models. Child U-As at 4.5 years (median: 57 µg/L), but not concurrent U-As (median: 29 µg/L), was positively associated with systolic (β=1.71) and diastolic BP (β=1.94) (p < 0.05) in adolescence. Concurrent U-As was non-linearly associated with CMD biomarkers at adolescence, with turning points at U-As 35 µg/L for BP and TG; and 20 µg/L for TC, LDL, HDL, glucose and HbA1C. Above the cut-off, the odds of exceeding normal ranges of systolic and diastolic BP, TC and TG were 1.70, 2.75, 1.90 and 2.25 times higher, respectively, while the odds of having HDL levels below the reference range was 2.70 times higher, compared to those having U-As below the cut-off. Sustained arsenic exposure from early childhood, at relatively low levels, was associated with dyslipidemia in adolescence.