Bangladesh is a densely populated developing country. Both industrialization and geological sources have caused widespread heavy metal and metalloid pollution in Bangladesh, which is now posing substantial threats to the local people. In this review, we carried out one of the most exhaustive literature analyses on the current status of Bangladesh heavy metal and metalloid pollution, covering water, soil, and foods. Analysis showed that soils near high traffic and industrial areas contain high concentrations of heavy metals and metalloids. Agricultural land and vegetables in sewage-irrigated areas were also found to be heavy metal- and metalloid-contaminated. River water, sediment, and fish from the Buriganga, Turag, Shitalakhya, and Karnaphuli rivers are highly contaminated with cadmium (Cd), lead (Pb), and chromium (Cr). Particularly, groundwater arsenic (As) pollution associated with high geological background levels in Bangladesh is well reported and is hitherto the largest mass poisoning in the world. Overall, the contamination levels of heavy metals and metalloids vary among the cities, with industrial areas being most polluted. In all, this review provides a quantitative identification of the As, Pb, Cd, and Cr contamination hotspots in Bangladesh based on the literature, which may be useful to environmental restorationists and local policy makers.

Skeletal muscle mass reduction has been implicated in insulin resistance (IR) that promotes cardiometabolic diseases. We have previously reported that arsenic exposure increases IR concomitantly with the reduction of skeletal muscle mass among individuals exposed to arsenic. The arsenic methylation capacity is linked to the susceptibility to some arsenic exposure-related diseases. However, it remains unknown whether the arsenic methylation capacity affects the arsenic-induced reduction of muscle mass and elevation of IR. Therefore, this study examined the associations between the arsenic methylation status and skeletal muscle mass measures with regard to IR by recruiting 437 participants from low- and high-arsenic exposure areas in Bangladesh. The subjects’ skeletal muscle mass was estimated by their lean body mass (LBM) and serum creatinine levels. Subjects’ drinking water arsenic concentrations were positively associated with total urinary arsenic concentrations and the percentages of MMA, as well as inversely associated with the percentages of DMA and the secondary methylation index (SMI). Subjects’ LBM and serum creatinine levels were positively associated with the percentage of DMA and SMI, as well as inversely associated with the percentage of MMA. HOMA-IR showed an inverse association with SMI, with a confounding effect of sex. Our results suggest that reduced secondary methylation capacity is involved in the arsenic-induced skeletal muscle loss that may be implicated in arsenic-induced IR and cardiometabolic diseases.