Arsenic Exposure in Relation to Ischemic Stroke
| Autor: | Ka He, Virginia J. Howard, Mary Cushman, John D. Brockman, Frederick W. Unverzagt, Vivian Montes de Oca Carioni, Cari Lewis Tsinovoi, Jianwen Cai, Pengcheng Xun, Leslie A. McClure, Eliseo Guallar |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Population chemistry.chemical_element 010501 environmental sciences 01 natural sciences Article Arsenicals Arsenic Brain Ischemia 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine education Stroke Aged 0105 earth and related environmental sciences Aged 80 and over Advanced and Specialized Nursing education.field_of_study Proportional hazards model business.industry Incidence Confounding Hazard ratio Middle Aged medicine.disease United States Confidence interval chemistry Cohort Female Neurology (clinical) Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Stroke. 49:19-26 |
| ISSN: | 1524-4628 0039-2499 |
| Popis: | Background and Purpose— The purpose of this case–cohort study was to examine urinary arsenic levels in relation to incident ischemic stroke in the United States. Methods— We performed a case–cohort study nested within the REGARDS (REasons for Geographic and Racial Differences in Stroke) cohort. A subcohort (n=2486) of controls was randomly sampled within region–race–sex strata while all incident ischemic stroke cases from the full REGARDS cohort (n=671) were included. Baseline urinary arsenic was measured by inductively coupled plasma-mass spectrometry. Arsenic species, including urinary inorganic arsenic and its metabolites monomethylarsonic acid and dimethylarsinic acid, were measured in a random subset (n=199). Weighted Cox’s proportional hazards models were used to calculate hazard ratios and 95% confidence intervals of ischemic stroke by arsenic and its species. Results— The average follow-up was 6.7 years. Although incident ischemic stroke showed no association with total arsenic or total inorganic arsenic, for each unit higher level of urinary monomethylarsonic acid on a log-scale, after adjustment for potential confounders, ischemic stroke risk increased ≈2-fold (hazard ratio=1.98; 95% confidence interval: 1.12–3.50). Effect modification by age, race, sex, or geographic region was not evident. Conclusions— A metabolite of arsenic was positively associated with incident ischemic stroke in this case–cohort study of the US general population, a low-to-moderate exposure area. Overall, these findings suggest a potential role for arsenic methylation in the pathogenesis of stroke, having important implications for future cerebrovascular research. |
| Databáze: | OpenAIRE |
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