Journal article
Arsenic Exposure in Relation to Ischemic Stroke: The Reasons for Geographic and Racial Differences in Stroke Study
Stroke (1970), v 49(1), pp 19-26
Jan 2018
PMID: 29212736
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The purpose of this case-cohort study was to examine urinary arsenic levels in relation to incident ischemic stroke in the United States.
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.
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.
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.
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Details
- Title
- Arsenic Exposure in Relation to Ischemic Stroke: The Reasons for Geographic and Racial Differences in Stroke Study
- Creators
- Cari L Tsinovoi - Indiana University BloomingtonPengcheng Xun - Indiana University BloomingtonLeslie A McClure - Drexel UniversityVivian M O CarioniJohn D Brockman - University of MissouriJianwen Cai - University of North Carolina at Chapel HillEliseo Guallar - University of North Carolina at Chapel HillMary Cushman - University of VermontFrederick W Unverzagt - University of North Carolina at Chapel HillVirginia J Howard - University of Alabama at BirminghamKa He - Indiana University Bloomington
- Publication Details
- Stroke (1970), v 49(1), pp 19-26
- Grant note
- R01 ES021735 / NIEHS NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000419030900018
- Scopus ID
- 2-s2.0-85043729437
- Other Identifier
- 991019168712804721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Peripheral Vascular Disease