Past arsenic exposure was found associated with increased incidence of type 2 diabetes. However, the mechanisms remain unclear. Metabolic syndrome has been shown as a strong predictor for diabetes occurrence. We aimed at examining the association of inorganic arsenic exposure and the prevalence of metabolic syndrome. The authors recruited 660 age and gender stratified random population of residents in central Taiwan during 2002-2003. They received home interviews and health examinations at local health care units, where blood and hair specimens were collected. Hair arsenic (H-As) concentrations were determined by inductively coupled plasma-mass spectrometry. Metabolic syndrome was defined as the presence of three or more of the following risk factors: elevated levels of blood pressure, plasma glucose, and triglycerides, also the body mass index, and reduced high-density lipoprotein. Prevalence of metabolic syndrome increased from the 2nd tertile (0.034 ug/g) of H-As levels (odds ratio=2.54, 95% confidence interval: 1.20-5.39, p=0.015) after the adjustment for age, gender, occupation and life styles including cigarette smoking. We further found linear relation between H-As concentrations and increased levels of plasma glucose and lipids, and blood pressures. This first report may help identify modifiable factors associated with diabetogenesis and cardiovascular disease progression and thus be worth following for community health. (c) 2007 Elsevier Ltd. All rights reserved.