Association between urinary tin concentration and diabetes in nationally representative sample of US adults

Buyun Liu, Yangbo Sun, Hans‐Joachim Lehmler, Wei Bao

Animal studies indicate that chronic exposure to certain tin compounds induces pancreatic islet cell apoptosis and glucose intolerance. However, little is known about health effects of environmental tin exposure in humans. We therefore evaluated the association of tin exposure with diabetes in a nationally representative sample of US adults. We used data from a nationally representative population (n=3,371) in the National Health and Nutrition Examination Survey 2011-2014. Diabetes (n = 605) was defined as a self-reported physician's diagnosis, a hemoglobin A1c level ≥ 6.5%, a fasting plasma glucose ≥ 126 mg/dL, or a two-hour plasma glucose ≥ 200 mg/dL. Tin concentrations in urine samples were determined by inductively coupled plasma mass spectrometry. We used logistic regression with sample weights to estimate the odds ratios (ORs) of diabetes and 95% confidence intervals (CIs). 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 risk factors of diabetes, the OR of diabetes comparing the highest with lowest quartile of urinary tin concentrations was 1.6 (95% CI, 1.0-2.6; P for trend = 0.02). Environmental tin exposure was positively and significantly associated with diabetes in US adults. This article is protected by copyright. All rights reserved.