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Peripheral Arterial Disease and Its Association With Arsenic Exposure and Metabolism in the Strong Heart Study.
- Source :
- American Journal of Epidemiology; 12/1/2016, Vol. 184 Issue 11, p806-817, 12p
- Publication Year :
- 2016
-
Abstract
- At high levels, inorganic arsenic exposure is linked to peripheral arterial disease (PAD) and cardiovascular disease. To our knowledge, no prior study has evaluated the association between low-to-moderate arsenic exposure and incident PAD by ankle brachial index (ABI). We evaluated this relationship in the Strong Heart Study, a large population-based cohort study of American Indian communities. A total of 2,977 and 2,966 PAD-free participants who were aged 45-74 years in 1989-1991 were reexamined in 1993-1995 and 1997-1999, respectively, for incident PAD defined as either ABI <0.9 or ABI >1.4. A total of 286 and 206 incident PAD cases were identified for ABI <0.9 and ABI >1.4, respectively. The sum of inorganic and methylated urinary arsenic species (ΣAs) at baseline was used as a biomarker of long-term exposure. Comparing the highest tertile of ΣAs with the lowest, the adjusted hazard ratios were 0.57 (95% confidence interval (CI): 0.32, 1.01) for ABI <0.9 and 2.24 (95% CI: 1.01, 4.32) for ABI >1.4. Increased arsenic methylation (as percent dimethylarsinate) was associated with a 2-fold increased risk of ABI >1.4 (hazard ratio = 2.04, 95% CI: 1.02, 3.41). Long-term low-to-moderate ΣAs and increased arsenic methylation were associated with ABI >1.4 but not with ABI <0.9. Further studies are needed to clarify whether diabetes and enhanced arsenic metabolism increase susceptibility to the vasculotoxic effects of arsenic exposure. [ABSTRACT FROM AUTHOR]
- Subjects :
- ARSENIC metabolism
ARSENIC
BIOMARKERS
CARDIOVASCULAR diseases
COMPARATIVE studies
CONFIDENCE intervals
DIABETES
HIGH performance liquid chromatography
HYPERTENSION
PSYCHOLOGY of Native Americans
LONGITUDINAL method
MASS spectrometry
PERIPHERAL vascular diseases
RESEARCH funding
SMOKING
URINALYSIS
MATHEMATICAL variables
ENVIRONMENTAL exposure
EDUCATIONAL attainment
BODY mass index
DISEASE incidence
PROPORTIONAL hazards models
ANKLE brachial index
CLUSTER sampling
Subjects
Details
- Language :
- English
- ISSN :
- 00029262
- Volume :
- 184
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- American Journal of Epidemiology
- Publication Type :
- Academic Journal
- Accession number :
- 120003476
- Full Text :
- https://doi.org/10.1093/aje/kww002