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Homocysteine Not Tied to Peripheral Arterial Disease

Association can be explained by confounding factors

FRIDAY, April 14 (HealthDay News) --The apparent association between homocysteine and peripheral arterial disease can be explained by confounding factors such as smoking, lead and cadmium exposure, and renal function, according to a study in the April 15 issue of the American Journal of Epidemiology.

Eliseo Guallar, M.D. Dr.P.H., and colleagues at Johns Hopkins Medical Institutions in Baltimore, Md., examined the association between homocysteine levels and peripheral arterial disease in 4,447 individuals 40 years or older who participated in the 1999 to 2002 National Health and Nutrition Examination Survey. Peripheral arterial disease was defined as an ankle-brachial blood pressure index less than 0.90 in at least one leg.

After adjusting for sociodemographic variables, individuals in the top quintile for homocysteine levels had a significantly higher risk of developing peripheral arterial disease than other subjects (odds ratio 1.92). However, the odds ratio was reduced to 0.89 after further adjustment for blood lead and cadmium levels, estimated glomerular filtration rate, and smoking, the study found.

"In the general population, the association of homocysteine level with [peripheral arterial disease] can be completely explained by confounding due to smoking, increased blood lead and cadmium levels, and impaired renal function," Guallar and colleagues concluded.

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