Elevated lipid profile associated with arsenic exposure and assessment of zinc deficiency in diabetes patients in Indian state of Bihar

Abstract Background: Heavy metal exposure is a significant environmental health concern that can be deadly due to bioaccumulation of toxic metals in the human body ultimately leading to alterations in physiology, disease severity, and risk of comorbid diseases. Certain metals including arsenic have been linked to hyperglycemia and a greater risk of diabetes. Bihar is one of the most-affected areas in terms of arsenic pollution. Numerous studies elucidated the effect of arsenic. This study is a single-centered pilot prospective cohort study aimed at evaluating the potential role of arsenic exposure and assessment of micronutrient levels in type 2 diabetes mellitus patients. A total of n=30 type-2 diabetic patients and healthy individuals aged > 18 years residing in arsenic endemic zones of Bihar, were initially recruited to assess arsenic levels in hair samples. Blood glucose parameters were found to be significantly greater (HbA1C, p=0.002* and postprandial blood sugar p=0.046 ) among the arsenic-exposed population than the others. Total cholesterol, Low density lipoprotein and triglycerides have positive correlations with arsenic levels, whereas High density lipoprotein displays a negative correlation with arsenic level. Zinc levels of diabetic patients are low compared to the healthy control group. Weak negative correlations are found with blood sugar parameters and zinc levels. Arsenic levels are also negatively correlated to zinc levels ( r=-0.458, p=0.042 ). Concludedly, Arsenic exposure has deleterious effect on blood glucose levels and lipid parameters. Preventive measures should be implemented to limit the exposure. Deficiently found trace elements such as zinc must be supplemented as a part of therapy for improving blood glucose parameters.