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2215737 
Journal Article 
Body composition and arsenic metabolism: a cross-sectional analysis in the Strong Heart Study 
Gribble, MO; Crainiceanu, CM; Howard, BV; Umans, JG; Francesconi, KA; Goessler, W; Zhang, Y; Silbergeld, EK; Guallar, E; Navas-Acien, A 
2013 
Environmental Health
EISSN: 1476-069X 
12 
107 
English 
Objective
The objective of this study was to evaluate the association between measures of body composition and patterns of urine arsenic metabolites in the 1989–1991 baseline visit of the Strong Heart Study, a cardiovascular disease cohort of adults recruited from rural communities in Arizona, Oklahoma, North Dakota and South Dakota.

Methods
We evaluated 3,663 Strong Heart Study participants with urine arsenic species above the limit of detection and no missing data on body mass index, % body fat and fat free mass measured by bioelectrical impedance, waist circumference and other variables. We summarized urine arsenic species patterns as the relative contribution of inorganic (iAs), methylarsonate (MMA) and dimethylarsinate (DMA) species to their sum. We modeled the associations of % arsenic species biomarkers with body mass index, % body fat, fat free mass, and waist circumference categories in unadjusted regression models and in models including all measures of body composition. We also considered adjustment for arsenic exposure and demographics.

Results
Increasing body mass index was associated with higher mean % DMA and lower mean % MMA before and after adjustment for sociodemographic variables, arsenic exposure, and for other measures of body composition. In unadjusted linear regression models, % DMA was 2.4 (2.1, 2.6) % higher per increase in body mass index category (< 25, ≥25 & <30, ≥30 & <35, ≥35 kg/m2), and % MMA was 1.6 (1.4, 1.7) % lower. Similar patterns were observed for % body fat, fat free mass, and waist circumference measures in unadjusted models and in models adjusted for potential confounders, but the associations were largely attenuated or disappeared when adjusted for body mass index.

Conclusion
Measures of body size, especially body mass index, are associated with arsenic metabolism biomarkers. The association may be related to adiposity, fat free mass or body size. Future epidemiologic studies of arsenic should consider body mass index as a potential modifier for arsenic-related health effects. 
American Indians; Arsenic; Arsenic metabolism; Arsenic species; Obesity; Body mass index; Strong Heart Study 
IRIS
• Arsenic Hazard ID
          PubMed
          Considered New
          WOS
          WOS
          Excluded
               WOS Duplicates
     2. Lit Search Updates through Oct 2015
          PubMed
          WOS
          Considered
• Arsenic (Inorganic)
     1. Literature
          Lit search updates through Oct 2015
     5. Susceptibility Screening
          Excluded/Not relevant
• Arsenic Susceptibility
     4. Susceptibility and Lifestages
          Nutritional deficiencies (includes socioeconomic status and BMI)
     5. Health Effect
          Not Relevant
     1. Susceptibility Literature Screening
          Keyword Search
     2. Excluded
          Not Relevant
     3. References Identified During Review
     Life Stages Citation Mapping
          Top 5%
• LitSearch-NOx (2024)
     Forward Citation Search
          Exposure
               Results
                    Error Impacts
                         PubMed
                         WoS