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El plomo, el cadmio, el tabaquismo y el aumento del riesgo de enfermedad arterial periférica
Ana Navas-Acien1, Elizabeth Selvin, A Richey Sharrett
1Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md, USA.
Circulation
|June 9, 2004
Resumen
La exposición crónica a dosis bajas de plomo y cadmio está relacionada con un mayor riesgo de enfermedad arterial periférica. Incluso los niveles por debajo de los estándares de seguridad muestran una asociación significativa, con el cadmio potencialmente mediando el tabaquismo.
Área de la Ciencia:
- Salud Ambiental Salud del medio ambiente.
- Epidemiología de las enfermedades cardiovasculares.
- Toxicología Toxicología.
Sus antecedentes:
- La aterosclerosis puede ser promovida por la exposición al plomo y al cadmio.
- Los efectos cardiovasculares de la exposición crónica a dosis bajas siguen siendo en gran medida desconocidos.
- La enfermedad arterial periférica (EAP) es un resultado cardiovascular significativo.
Objetivo del estudio:
- Evaluar la asociación entre los niveles de plomo y cadmio en la sangre y la enfermedad arterial periférica (EAP).
- Para investigar el impacto de la exposición crónica a dosis bajas de metales pesados en la salud cardiovascular.
- Evaluar la contribución de los metales pesados a la prevalencia de la EAP en la población de los Estados Unidos.
Principales métodos:
- Análisis de 2125 participantes mayores de 40 años de la Encuesta Nacional de Salud y Nutrición de 1999-2000 (NHANES).
- Enfermedad arterial periférica (EAP) definida por el índice tobillo-braquial <0.9.
- Los niveles de plomo y cadmio en sangre medidos mediante espectrometría de absorción atómica; análisis estadístico ajustado por factores de confusión.
Principales resultados:
- El aumento de los odds ratios (ORs) para la EAP se asocia con cuartiles más altos de plomo en la sangre (tendencia P=0,02) y cadmio (tendencia P=0,01).
- Se observaron ORs elevados para PAD incluso con niveles de plomo y cadmio en sangre por debajo de las normas de seguridad actuales.
- El tabaquismo mostró una OR más alta para la PAD, que se redujo después de ajustar los niveles de plomo y cadmio.
Conclusiones:
- El plomo y el cadmio en la sangre se asocian con un aumento de la prevalencia de EAP en la población general de los Estados Unidos.
- Estas asociaciones existen a niveles por debajo de las normas de seguridad actuales.
- El cadmio puede mediar parcialmente el efecto perjudicial del tabaquismo en la enfermedad arterial periférica (EAP).
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