Arsenic exposure in relation to ischemic stroke: The reasons for geographic and racial differences in stroke study
Tsinovoi, CL; Xun, P; Mcclure, LA; Carioni, VMO; Brockman, JD; Cai, J; Guallar, E; Cushman, M; Unverzagt, FW; Howard, VJ; He, K
HERO ID
4242100
Reference Type
Journal Article
Year
2018
Language
English
PMID
| HERO ID | 4242100 |
|---|---|
| In Press | No |
| Year | 2018 |
| Title | Arsenic exposure in relation to ischemic stroke: The reasons for geographic and racial differences in stroke study |
| Authors | Tsinovoi, CL; Xun, P; Mcclure, LA; Carioni, VMO; Brockman, JD; Cai, J; Guallar, E; Cushman, M; Unverzagt, FW; Howard, VJ; He, K |
| Journal | Stroke |
| Volume | 49 |
| Issue | 1 |
| Page Numbers | 19-26 |
| Abstract | <strong>BACKGROUND AND PURPOSE: </strong>The purpose of this case-cohort study was to examine urinary arsenic levels in relation to incident ischemic stroke in the United States.<br /><br /><strong>METHODS: </strong>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.<br /><br /><strong>RESULTS: </strong>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.<br /><br /><strong>CONCLUSIONS: </strong>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. |
| Doi | 10.1161/STROKEAHA.117.018891 |
| Pmid | 29212736 |
| Wosid | WOS:000419030900018 |
| Is Certified Translation | No |
| Dupe Override | No |
| Is Public | Yes |
| Language Text | English |