| Authors |
Newman JD, Navas-Acien A, Kuo CC, Guallar E, Howard BV, Fabsitz RR, Devereux RB,
Umans JG, Francesconi KA, Goessler W, Best LT, Tellez-Plaza M
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| Submitted By |
Jonathan Newman on 12/7/2016 |
| Status |
Published |
| Journal |
American journal of epidemiology |
| Year |
2016 |
| Date Published |
12/1/2016 |
| Volume : Pages |
184 : 806 - 817 |
| PubMed Reference |
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| 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 (?As)
at baseline was used as a biomarker of long-term exposure. Comparing the highest
tertile of ?As 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聽=聽2.04, 95%
CI: 1.02, 3.41). Long-term low-to-moderate ?As 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.
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