Skip directly to search Skip directly to A to Z list Skip directly to page options Skip directly to site content

NIOSHTIC-2 Publications Search

Search Results

Confounding of the relation between homocysteine and peripheral arterial disease by lead, cadmium, and renal function.

Authors
Guallar-E; Silbergeld-EK; Navas-Acien-A; Malhotra-S; Astor-BC; Sharrett-AR; Schwartz-BS
Source
Am J Epidemiol 2006 Apr; 163(8):700-708
NIOSHTIC No.
20037666
Abstract
Homocysteine levels are associated with peripheral arterial disease (PAD) in observational studies. Lead and cadmium are risk factors for PAD that affect thiol metabolism, and they may partly explain the association of homocysteine with PAD. To evaluate the roles of lead and cadmium exposure in confounding the association between homocysteine and PAD, the authors performed a cross-sectional study among 4,447 persons aged > or = 40 years who participated in the 1999-2002 National Health and Nutrition Examination Survey (NHANES). PAD was defined as an ankle-brachial blood pressure index less than 0.90 in at least one leg. After adjustment for sociodemographic variables, the odds ratio for PAD in the highest quintile of homocysteine compared with the lowest was 1.92 (p(trend) = 0.004). Adjusting for blood lead and cadmium levels reduced this odds ratio to 1.37 (p(trend) = 0.13), and further adjusting for estimated glomerular filtration rate and smoking reduced it to 0.89 (p(trend) = 0.87). Adjustment for other risk factors did not affect this association. In the general population, the association of homocysteine level with PAD can be completely explained by confounding due to smoking, increased blood lead and cadmium levels, and impaired renal function. The association of lead and cadmium with PAD risk deserves further investigation.
Keywords
Circulatory-system; Lead-absorption; Lead-poisoning; Cadmium-poisoning; Cadmium-compounds; Exposure-levels; Heavy-metals; Author Keywords: cadmium; glomerular filtration rate; homocysteine; lead; peripheral vascular diseases; smoking; CI; confidence interval; NHANES; National Health and Nutrition Examination Survey; PAD; peripheral arterial disease
Contact
Dr. Eliseo Guallar, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, 2024 East Monument Street, Suite 2-639, Baltimore, MD 21205-2223
CODEN
AJEPAS
CAS No.
7439-92-1; 7440-43-9
Publication Date
20060415
Document Type
Journal Article
Email Address
eguallar@jhsph.edu
Funding Type
Grant
Fiscal Year
2006
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-T42-OH-008428
Issue of Publication
8
ISSN
0002-9262
Source Name
American Journal of Epidemiology
State
MD
Performing Organization
Johns Hopkins University
TOP