Anthropometric measures and arsenic methylation among pregnant women in rural northern Bangladesh

Tyler J S Smith; Ana Navas-Acien; Sarah Baker; Caryn Kok; Kate Kruczynski; Lindsay N Avolio; Nora Pisanic; Pranay R Randad; Rebecca C Fry; Walter Goessler; Alexander van Geen; Jessie P Buckley; Md Hafizur Rahman; Hasmot Ali; Rezwanul Haque; Saijuddin Shaikh; Towfida J Siddiqua; Kerry Schulze; Keith P West Jr; Alain B Labrique; Christopher D Heaney

doi:10.1016/j.envres.2023.116453

Anthropometric measures and arsenic methylation among pregnant women in rural northern Bangladesh

Environ Res. 2023 Oct 1:234:116453. doi: 10.1016/j.envres.2023.116453. Epub 2023 Jun 19.

Authors

Tyler J S Smith¹, Ana Navas-Acien², Sarah Baker³, Caryn Kok⁴, Kate Kruczynski⁴, Lindsay N Avolio⁴, Nora Pisanic⁴, Pranay R Randad⁴, Rebecca C Fry⁵, Walter Goessler⁶, Alexander van Geen⁷, Jessie P Buckley⁸, Md Hafizur Rahman⁹, Hasmot Ali⁹, Rezwanul Haque⁹, Saijuddin Shaikh⁹, Towfida J Siddiqua⁹, Kerry Schulze³, Keith P West Jr³, Alain B Labrique³, Christopher D Heaney¹⁰

Affiliations

¹ Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: tylersmith@jhu.edu.
² Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
³ Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁴ Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁵ Department of Environmental Sciences & Engineering, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA.
⁶ Institute of Chemistry - Analytical Chemistry, University of Graz, Graz, Austria.
⁷ Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY, USA.
⁸ Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁹ JiVitA Maternal and Child Health and Nutrition Research Project, Rangpur, Bangladesh.
¹⁰ Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Abstract

Introduction: Arsenic methylation converts inorganic arsenic (iAs) to monomethyl (MMA) and dimethyl (DMA) arsenic compounds. Body mass index (BMI) has been positively associated with arsenic methylation efficiency (higher DMA%) in adults, but evidence in pregnancy is inconsistent. We estimated associations between anthropometric measures and arsenic methylation among pregnant women in rural northern Bangladesh.

Methods: We enrolled pregnant women (n = 784) (median [IQR] gestational week: 14 [13, 15]) in Gaibandha District, Bangladesh from 2018 to 2019. Anthropometric measures were BMI, subscapular and triceps skinfold thicknesses, and mid-upper arm circumference (MUAC), fat area (MUAFA), and muscle area (MUAMA). Arsenic methylation measures were urinary iAs, MMA, and DMA divided by their sum and multiplied by 100 (iAs%, MMA%, and DMA%), primary methylation index (MMA/iAs; PMI), and secondary methylation index (DMA/MMA; SMI). In complete cases (n = 765 [97.6%]), we fitted linear, beta, and Dirichlet regression models to estimate cross-sectional differences in iAs%, MMA%, DMA%, PMI, and SMI per IQR-unit difference in each anthropometric measure, adjusting for drinking water arsenic, age, gestational age, education, living standards index, and plasma folate, vitamin B12, and homocysteine.

Results: Median (IQR) BMI, subscapular skinfold thickness, triceps skinfold thickness, MUAC, MUAFA, and MUAMA were 21.5 (19.4, 23.8) kg/m², 17.9 (13.2, 24.2) mm, 14.2 (10.2, 18.7) mm, 25.9 (23.8, 28.0) cm, 15.3 (10.5, 20.3) cm², and 29.9 (25.6, 34.2) cm², respectively. Median (IQR) iAs%, MMA%, DMA%, PMI, and SMI were 12.0 (9.3, 15.2)%, 6.6 (5.3, 8.3)%, 81.0 (77.1, 84.6)%, 0.6 (0.4, 0.7), and 12.2 (9.3, 15.7), respectively. In both unadjusted and adjusted linear models, all anthropometric measures were negatively associated with iAs%, MMA%, and PMI and positively associated with DMA% and SMI. For example, fully adjusted mean differences (95% CI) in DMA% per IQR-unit difference in BMI, subscapular skinfolds thickness, triceps skinfold thickness, MUAC, MUAFA, and MUAMA were 1.72 (1.16, 2.28), 1.58 (0.95, 2.21), 1.74 (1.11, 2.37), 1.45 (0.85, 2.06), 1.70 (1.08, 2.31), and 0.70 (0.13, 1.27) pp, respectively.

Conclusions: Anthropometric measures were positively associated with arsenic methylation efficiency among pregnant women in the early second trimester.

Keywords: Adiposity; Anthropometry; Arsenic metabolism; Micronutrient status; One-carbon metabolism; Pregnancy.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Arsenic* / analysis
Arsenicals*
Bangladesh
Cross-Sectional Studies
Environmental Exposure / analysis
Female
Humans
Methylation
Pregnancy
Pregnant Women

Substances

Arsenic
Arsenicals

Abstract

Publication types

MeSH terms

Substances

Grants and funding