Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2005 Feb;113(2):164-9.
doi: 10.1289/ehp.7329.

Metals in urine and peripheral arterial disease

Ana Navas-Acien  1 , Ellen K Silbergeld, Richey Sharrett, Emma Calderon-Aranda, Elizabeth Selvin, Eliseo Guallar
Affiliations

Metals in urine and peripheral arterial disease

Ana Navas-Acien et al. Environ Health Perspect. 2005 Feb.

Abstract

Exposure to metals may promote atherosclerosis. Blood cadmium and lead were associated with peripheral arterial disease (PAD) in the 1999-2000 National Health and Nutrition Examination Survey (NHANES). In the present study we evaluated the association between urinary levels of cadmium, lead, barium, cobalt, cesium, molybdenum, antimony, thallium, and tungsten with PAD in a cross-sectional analysis of 790 participants > or =40 years of age in NHANES 1999-2000. PAD was defined as a blood pressure ankle brachial index < 0.9 in at least one leg. Metals were measured in casual (spot) urine specimens by inductively coupled plasma-mass spectrometry. After multivariable adjustment, subjects with PAD had 36% higher levels of cadmium in urine and 49% higher levels of tungsten compared with noncases. The adjusted odds ratio for PAD comparing the 75th to the 25th percentile of the cadmium distribution was 3.05 [95% confidence interval (CI), 0.97 to 9.58]; that for tungsten was 2.25 (95% CI, 0.97 to 5.24). PAD risk increased sharply at low levels of antimony and remained elevated beyond 0.1 microg/L. PAD was not associated with other metals. In conclusion, urinary cadmium, tungsten, and possibly antimony were associated with PAD in a representative sample of the U.S. population. For cadmium, these results strengthen previous findings using blood cadmium as a biomarker, and they support its role in atherosclerosis. For tungsten and antimony, these results need to be interpreted cautiously in the context of an exploratory analysis but deserve further study. Other metals in urine were not associated with PAD at the levels found in the general population.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Metal levels in urine (μg/L) by participant characteristics. Horizontal lines, interquartile ranges; squares, medians; dotted vertical line, the geometric mean for the overall study sample.
Figure 2
Figure 2. Odds ratios of PAD by metal levels in urine. The curves are odds ratios adjusted for age, sex, race, education, smoking, and urinary creatinine based on restricted cubic spline transformations. The reference value (odds ratio = 1) was set at the 10th percentile of the distribution for each metal. The bar histograms represent the frequency distribution of each metal in the study sample. The tick marks at the bottom of the histogram represent the metal level of the cases of PAD.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Aalbers TG, Houtman JP. Relationships between trace elements and atherosclerosis. Sci Total Environ. 1985;43:255–283. - PubMed
    1. Adamska-Dyniewska H, Bala T, Florczak H, Trojanowska B. Blood cadmium in healthy subjects and in patients with cardiovascular diseases. Cor Vasa. 1982;24:441–447. - PubMed
    1. ATSDR 1992a. Toxicological Profile for Antimony. Atlanta, GA:Agency for Toxic Substances and Disease Registry. - PubMed
    1. ATSDR 1992b. Toxicological Profile for Thallium. Atlanta, GA:Agency for Toxic Substances and Disease Registry.
    1. ATSDR 1999a. Toxicological Profile for Cadmium. Atlanta, GA:Agency for Toxic Substances and Disease Registry. - PubMed

Publication types

LinkOut - more resources

-