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

AI Article Synopsis

  • Observational studies link homocysteine levels to peripheral arterial disease (PAD), with lead and cadmium acting as potential confounders due to their effects on thiol metabolism.* -
  • A study analyzed data from 4,447 participants aged 40 and older, finding that higher homocysteine levels initially correlated with an increased risk of PAD, but this association was significantly weakened after adjusting for lead, cadmium, and other factors.* -
  • Ultimately, the study concludes that the relationship between homocysteine and PAD can be attributed to confounding factors like smoking and blood metal levels, suggesting a need for further research on lead and cadmium's roles in PAD risk.*

Article 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.

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Source
http://dx.doi.org/10.1093/aje/kwj090DOI Listing

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