Association of urinary arsenic concentrations with inflammation: Overall and by folate intake, body mass index, and gender Journal Article


Authors: Gonzalez, G. F.; O'Connell, K.; Du, M.; Romano, M. E.; Kantor, E. D.
Article Title: Association of urinary arsenic concentrations with inflammation: Overall and by folate intake, body mass index, and gender
Abstract: Background: Inorganic arsenic (iA) exposure is associated with increased risk of lung, bladder, and skin cancer, as well as cardiovascular disease and diabetes. C-reactive protein (CRP), a measurement of inflammation, has been associated with these conditions. As the relationship between urinary arsenic and CRP remains unclear, we aim to determine if there is an association and to examine effect modification by dietary and lifestyle factors. Methods: The study includes 5761 adults, ages 25+, over four survey cycles (2005–2006, 2007–2008, 2009–2010, and 2015–2016), surveyed as part of the National Health and Nutrition Examination Survey (NHANES) and included in the laboratory subsample. Survey-weighted multivariable linear regression was used to determine the association between log-transformed arsenic concentrations (∑As, monomethylarsonate [MMA], and dimethylarsinate [DMA], and primary and secondary methylation indices [PMI, SMI]) and log-transformed CRP. Models were stratified by gender, body mass index (BMI), folic acid supplement use, and dietary folate intake. Results: Three forms of urinary arsenic were associated with statistically significant lower levels of CRP (∑As: −3.06 %, MMA: −2.34 %, DMA: −2.10 %, per 25 % increase in arsenic concentration). The association between SMI and CRP varied by gender (p-interaction: <0.01) and dietary folate intake (p-interaction: 0.04). Conclusions: The inverse association between urinary arsenic concentrations and CRP was unexpected, highlighting a need to better characterize effects of iAs at low levels of exposure. Effect modification by dietary folate intake suggests that folate may affect the secondary methylation pathway, however, more research is needed to understand the role that folic acid plays in arsenic methylation. © 2025 Elsevier GmbH
Keywords: adult; aged; middle aged; c reactive protein; metabolism; inflammation; c-reactive protein; diet; body mass; body mass index; urine; folic acid; epidemiology; sex factors; environmental exposure; nutrition; pollutant; environmental pollutants; arsenic; humans; human; male; female; nutrition surveys; sex factor
Journal Title: International Journal of Hygiene and Environmental Health
Volume: 267
Issue: 114585
ISSN: 1438-4639
Publisher: Elsevier Gmbh  
Date Published: 2025-06-01
Start Page: 114585
Language: English
DOI: 10.1016/j.ijheh.2025.114585
PUBMED: 40441120
PROVIDER: scopus
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Elizabeth D. Kantor -- Source: Scopus
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MSK Authors
  1. Elizabeth David Kantor
    44 Kantor
  2. Mengmeng   Du
    75 Du