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

Details

• Personal Author:
  Astor BC ; Guallar E ; Malhotra S ; Navas-Acien A ; Schwartz BS ; Sharrett AR ; Silbergeld EK
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Cadmium Cardiovascular System Lead Lead Poisoning Metals, Heavy Occupational Health Poisoning Safety
• Keywords:
  Author Keywords: Cadmium Cadmium-compounds Cadmium-poisoning CI Circulatory-system Confidence Interval Exposure-levels Glomerular Filtration Rate Heavy-metals Homocysteine Lead Lead-absorption Lead-poisoning National Health And Nutrition Examination Survey NHANES PAD Peripheral Arterial Disease Peripheral Vascular Diseases Smoking

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• ISSN:
  0002-9262
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Maryland ; OSHA Region 3
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  163
• Issue:
  8
• NIOSHTIC Number:
  nn:20037666
• Citation:
  Am J Epidemiol 2006 Apr; 163(8):700-708
• Contact Point Address:
  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
• Email:
  eguallar@jhsph.edu
• CAS Registry Number:
  Cadmium (CAS RN 7440-43-9) ; Lead (CAS RN 7439-92-1)
• Federal Fiscal Year:
  2006
• Performing Organization:
  Johns Hopkins University
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  American Journal of Epidemiology
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:cea92505136b9b2910f41153b3f95b99096f1f34ead9fde9de5b3be45d37709383778da2142682cc03c3e27ecfb685ba997b7a4dd6b6292809634e65dbe0277e
• Download URL:
  https://stacks.cdc.gov/view/cdc/191664/cdc_191664_DS1.pdf
• File Type:
  [PDF - 209.89 KB ]