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Argos M.,University of Chicago | Rahman M.,UChicago Research Bangladesh URB Ltd. | Parvez F.,Columbia University | Dignam J.,University of Chicago | And 18 more authors.
European Journal of Clinical Investigation | Year: 2013

Background: Epidemiologic research suggests that increased cancer risk due to chronic arsenic exposure persists for several decades even after the exposure has terminated. Observational studies suggest that antioxidants exert a protective effect on arsenical skin lesions and cancers among those chronically exposed to arsenic through drinking water. This study reports on the design, methods and baseline analyses from the Bangladesh Vitamin E and Selenium Trial (BEST), a population-based chemoprevention study conducted among adults in Bangladesh with visible arsenic toxicity. Materials and methods: Bangladesh Vitamin E and Selenium Trial is a 2×2 full factorial, double-blind, randomized controlled trial of 7000 adults having manifest arsenical skin lesions evaluating the efficacy of 6-year supplementation with alpha-tocopherol (100 mg daily) and L-selenomethionine (200 μg daily) for the prevention of nonmelanoma skin cancer. Results: In cross-sectional analyses, we observed significant associations of skin lesion severity with male gender (female prevalence odds ratio (POR) = 0·87; 95% CI = 0·79-0·96), older age (aged 36-45 years, POR = 1·27; 95% CI = 1·13-1·42; aged 46-55 years, POR = 1·44; 95% CI = 1·27-1·64 and aged 56-65 years, POR = 1·50; 95% CI = 1·26-1·78 compared with aged 25-35 years), hypertension (POR = 1·29; 95% CI = 1·08-1·55), diabetes (POR = 2·13; 95% CI = 1·32-3·46), asthma (POR = 1·55; 95% CI = 1·03-2·32) and peptic ulcer disease (POR = 1·20; 95% CI = 1·07-1·35). Conclusions: We report novel associations between arsenical skin lesions with several common chronic diseases. With the rapidly increasing burden of preventable cancers in developing countries, efficient and feasible chemoprevention study designs and approaches, such as employed in BEST, may prove both timely and potentially beneficial in conceiving cancer chemoprevention trials in Bangladesh and beyond. © 2013 Stichting European Society for Clinical Investigation Journal Foundation.

Argos M.,University of Chicago | Parvez F.,Columbia University | Rahman M.,U Chicago Research Bangladesh URB Ltd. | Rakibuz-Zaman M.,U Chicago Research Bangladesh URB Ltd. | And 11 more authors.
Epidemiology | Year: 2014

BACKGROUND: Chronic arsenic exposure through drinking water is a public health problem affecting millions of people worldwide, including at least 30 million in Bangladesh. We prospectively investigated the associations of arsenic exposure and arsenical skin lesion status with lung disease mortality in Bangladeshi adults. METHODS: Data were collected from a population-based sample of 26,043 adults, with an average of 8.5 years of follow-up (220,157 total person-years). There were 156 nonmalignant lung disease deaths and 90 lung cancer deaths ascertained through October 2013. We used Cox proportional hazards models to estimate adjusted hazard ratios and 95% confidence intervals (CIs) for lung disease mortality. RESULTS: Creatinine-adjusted urinary total arsenic was associated with nonmalignant lung disease mortality, with persons in the highest tertile of exposure having a 75% increased risk for mortality (95% CI = 1.15-2.66) compared with those in the lowest tertile of exposure. Persons with arsenical skin lesions were at increased risk of lung cancer mortality (hazard ratio = 4.53 [95% CI = 2.82-7.29]) compared with those without skin lesions. CONCLUSIONS: This prospective investigation of lung disease mortality, using individual-level arsenic measures and skin lesion status, confirms a deleterious effect of ingested arsenic on mortality from lung disease. Further investigations should evaluate effects on the incidence of specific lung diseases, more fully characterize dose-response, and evaluate screening and biomedical interventions to prevent premature death among arsenic-exposed populations, particularly among those who may be most susceptible to arsenic toxicity. Copyright © 2014 by Lippincott Williams & Wilkins.

Argos M.,University of Chicago | Tong L.,University of Chicago | Pierce B.L.,University of Chicago | Rakibuz-Zaman M.,U Chicago Research Bangladesh URB . Ltd. | And 9 more authors.
Journal of Medical Genetics | Year: 2014

Background: The high prevalence of tobacco use in some developing nations, including Bangladesh, poses several public health challenges for these populations. Smoking behaviour is determined by genetic and environmental factors; however, the genetic determinants of smoking behaviour have not been previously examined in a Bangladeshi or South Asian population. We performed a genome-wide association study (GWAS) of tobacco smoking behaviour among a population-based sample of 5354 (2035 ever smokers and 3319 never smokers) men and women in Bangladesh. Methods: Genome-wide association analyses were conducted for smoking initiation (ever vs never smokers), smoking quantity (cigarettes per day), age of smoking initiation, and smoking cessation (former vs current smokers). Sex-stratified associations were performed for smoking initiation. Results: We observed associations for smoking initiation in the SLC39A11 region at 17q21.31 (rs2567519, p=1.33×10-7) among men and in the SLCO3A1 region at 15q26 (rs12912184, p=9.32×10-8) among women. Conclusions: These findings suggest possible underlying mechanisms related to solute carrier transporter genes, which transport neurotransmitters, nutrients, heavy metals and other substrates into cells, for smoking initiation in a South Asian population in a sex-specific pattern. Genetic markers could have potential translational implications for the prevention or treatment of tobacco use and addiction in South Asian populations and warrant further exploration.

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