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The study was conducted in Hanghou County of Inner Mongolia, China. Populations living in this area mainly rely on groundwater for drinking and domestic use. Arseniasis caused by consumption of drinking groundwater containing high levels of naturally occurring arsenic has been reported[34]. The lowest prevalence of skin lesions in females and males were 8.1% and 15.6%, observed in the < 20-year age group. This value increased to 59.3% in the 51-60-year age group of for males[23]. In the present study, the highest arsenic concentration in groundwater was 824.70 μg/L.
The study setting was home-based. Residents who had lived in the study area for more than 10 years were considered as eligible subjects. Residents who had consumed seafood in the past week and who were taking anti-hypertensive drugs were excluded. Pregnant and breastfeeding women were also excluded. Finally, 560 residents, including 399 (71.25%) females and 161 (28.75%) males, were selected as study subjects. The demographic characteristics of the study subjects are listed in Table 1. Informed consent was read and signed by all subjects before performing a detailed interview. Information about demographic characteristics, socioeconomic status, cigarette smoking and alcohol consumption history, dietary habits, type of work, medical history, and education level attained were obtained by well-trained interviewers using a structured questionnaire. The measurement of standing height and body weight were conducted by trained physicians. Body mass index (BMI) was computed as weight in kilograms divided by height in square meters. The results are represented in Table 1. The present study was conducted according to the Declaration of Helsinki Ethical Principles for Medical Research Involving Human Subjects.
Table 1. The Characteristics of the Study Subjects
Variables The arsenic levels in drinking water ≤ 10 μg/L 10-100 μg/L 100-300 μg/L > 300 μg/L Age 38.24 39.60 34.69 39.21 Gender Female (n = 399) 79 (69.91%) 127 (83.01%) 115 (64.97%) 78 (66.67) Male (n = 161) 34 (30.09%) 26 (16.99%) 62 (35.03%) 39 (33.33) Smoking Smoker 39 (34.51%) 39 (25.49%) 61 (34.46%) 43 (36.75%) Non-smoker 74 (65.49%) 114 (74.51%) 116 (65.54%) 74 (63.25%) Alcohol Drinker 8 (7.08%) 13 (8.50%) 29 (16.38%) 21 (17.95%) Non-drinker 105 (92.92%) 140 (91.50%) 148 (83.62%) 96 (82.05%) BMI < 18.5 8 (7.08%) 4 (2.62%) 8 (4.52%) 9 (7.69%) 18.5-25 72 (63.72%) 109 (71.24%) 130 (73.45%) 63 (53.85%) > 25 33 (29.20%) 40 (26.14%) 39 (22.03%) 45 (38.46%) -
Approximately 50 mL first-morning void urine was obtained from each subject in 100 mL polypropylene tubes. A total of 560 urine samples were collected. The collected urine samples were immediately kept in an icebox. Within 8 h, all the urine samples were transferred to the Inner Mongolia Center for Endemic Disease Control and Research in Hohhot and stored at -20 ℃ in a low-temperature refrigerator. Then, the urine samples were kept in an icebox and transported to the Laboratory of Arsenic Analysis in the Institute of Geographic Sciences and Natural Resources Research, CAS (Beijing, China), and stored in a low-temperature refrigerator for further analysis. Similarly, 50 mL of groundwater from tube wells used for drinking were collected from each of the studied households. Each family had their own well. Tube well water was pumped for approximately 5 min to collect water at the tip of the tap, and samples were then collected. The water samples were stored in clean 100-mL bottles at -20 ℃ in a low-temperature refrigerator.
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BP was measured by trained clinicians using the standard protocol recommended by the World Health rganization[35]. Each subject's BP was measured three times with a mercury sphygmomanometer in a sitting position after rest for at least 15 min. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were defined at the first and fifth Korotkoff sounds, respectively. The average value of the three measurements was taken as the proper value. An abnormal BP was defined as an average SBP ≥ 140 mmHg, or an average DBP ≥ 90 mmHg. PP was calculated by deducting DBP from SBP. A PP (pulse pressure) ≥ 55 mmHg was considered abnormal[36].
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A high-performance liquid chromatography/ hydride generator (HPLC) was used to separate arsenic species in urine[37]. The concentrations of iAs, MMA, and DMA in urine samples were determined by inductively coupled plasma mass spectrometry (ICP-MS). Total arsenic content in drinking water was determined by HPLC and ICP-MS. The detection limit of this method for arsenic species was 1 ng. A standard reference material containing 1000 mg/L iAs, MMA, and DMA (National Center for Standard Reference Materials) was used to check the validity of urinary arsenic species measurement. The reliability of arsenic species determination was evaluated in terms of the analytical recovery rate for added arsenic species. The recovery rate was 83%-94% for iAs, 91%-97% for MMA, and 90%-102% for DMA.
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CAE was assessed for each subject according their detailed water consumption history, exposure duration (years), and the number of days each subject stayed at home in each year. Lifetime CAE was defined as C × W × Y × D/1000 mg/L, where C is the arsenic concentration (μg/L) in the drinking water, W is the daily water consumption, Y is the exposure duration (years), and D is the number of days each subject stayed in the local home in each year.
Total arsenic concentration in urine (TAs) was the sum of arsenic metabolites, i.e., iAs + MMA + DMA. The arsenic methylation indices were defined as the percentages of respective arsenic species in urine. Therefore, the primary methylation index (PMI) was calculated as the ratio between MMA + DMA and TAs, and the secondary methylation index (SMI) was calculated as the ratio between DMA and MMA + DMA[38].
The Student's t-test and ANOVA were applied to evaluate the differences in urinary arsenic metabolites between the groups. A linear regression model was performed to analyze the relationships between BP (SBP, DBP, and PP) and CAE. Logistic regression models were further applied to estimate the multivariate-adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for the risk of abnormal BP. The models were constructed by the various arsenic metrics individually tested with adjustment for age, sex, BMI, etc.
In this study, all statistical analyses were performed using SPSS 18.0 software and Microsoft Excel 2007.
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The BP, including SBP, DBP, and PP, is listed in Table 2. It can be seen that the DBP, SBP, and PP were significantly different among the age groups. The values usually increased with age. The SBP and DBP varied slightly between males and females, whereas males had obviously higher PP than females. The SBP, DBP, and PP were significantly increased with the BMI of the study subjects. The DBP was considerably higher for smokers than for non-smokers, and the values of SBP and PP were slightly higher for smokers. The DBP, SBP, and PP varied slightly between drinkers and non-drinkers. Moreover, the DBP, SBP, and PP were usually higher in subjects with skin lesions than in those without skin lesions. Among subjects exposed to different levels of arsenic in drinking water, the DBP and SBP varied greatly, while the PP varied slightly. Subjects who were exposed to arsenic levels in the range of 10-100 μg/L in drinking water had the highest DBP and SBP.
Table 2. Blood pressure for the study subject
Items DBP SD SBP SD PP SD Age < 30 76.82 7.67 120.32 9.99 43.52 5.56 30-50 84.91 11.35 129.07 16.06 44.16 8.19 > 50 89.93 14.57 137.64 22.40 48.09 10.93 P (ANOVA) < 0.0001 < 0.0001 < 0.0001 Gender Male 83.49 12.52 128.65 18.22 45.17 8.96 Female 83.66 11.06 127.12 14.28 43.73 6.46 P (t-test) 0.879 0.292 0.034 BMI < 18.5 75.75 9.54 118.82 12.22 43.09 5.26 18.5-25 82.45 11.64 126.74 16.67 44.41 8.21 > 25 89.01 11.83 135.17 17.50 46.19 9.36 P (ANOVA) < 0.0001 < 0.0001 0.025 Smoking Y 85.44 10.90 129.99 15.71 44.79 8.23 N 82.79 12.49 127.51 17.69 44.74 8.38 P (t-test) 0.020 0.126 0.951 Alcohol Y 84.84 9.21 129.10 13.20 44.19 6.90 N 83.37 12.43 128.10 17.63 44.83 8.50 P (t -test) 0.364 0.664 0.568 Skin lesion With 85.28 11.83 129.99 17.75 44.91 9.12 Without 82.75 12.17 127.41 16.88 44.69 7.97 P (t-test) 0.022 0.100 0.773 As content (μg/L) < 10 84.32 11.46 129.12 16.30 44.86 8.02 10-100 85.29 13.35 130.37 18.81 45.09 9.31 100-300 81.51 10.63 125.14 14.26 43.60 6.54 > 300 83.55 12.81 129.14 19.27 45.97 9.51 P (ANOVA) 0.034 0.033 0.105 -
The concentrations and proportions of arsenic metabolites and the arsenic methylation capacity index are displayed in Table 3. The concentrations of iAs, MMA, DMA, and TAs in the urine of subjects with DBP higher than 90 mmHg were 59.32, 52.44, 228.08, and 339.44 μg/L, respectively, whereas the values for subjects with DBP lower than 90 mmHg were 49.97, 44.17, 187.55, and 281.09 μg/L, respectively. Similarly, subjects with SBP higher than 140 mmHg had higher urinary contents of iAs, MMA, DMA, and TAs than subjects with SBP lower than 140 mmHg. In addition, higher urinary concentrations of iAs, MMA, DMA, and TAs were observed for subjects with PP higher than 55 mmHg.
Table 3. Urinary arsenic metabolites and methyllation capacity index of the subjects
Variables DBP SBP PP > 90 mmHg < 90 mmHg P > 140 mmHg < 140 mmHg P > 55 mmHg < 55 mmHg P iAs 59.32 49.97 0.195 54.80 51.50 0.668 56.48 51.60 0.612 MMA 52.44 44.17 0.210 49.95 45.17 0.472 45.65 46.16 0.950 DMA 228.08 187.55 0.075 221.47 191.04 0.274 208.00 195.56 0.683 TAs 339.44 281.09 0.091 325.76 287.11 0.350 310.12 292.67 0.705 iAs% 15.81 15.74 0.933 14.78 16.00 0.163 14.78 15.88 0.313 MMA% 13.89 14.13 0.613 13.57 14.19 0.214 13.91 14.09 0.781 DMA% 70.30 70.13 0.867 71.65 69.81 0.088 71.30 70.03 0.399 PMI 0.84 0.83 0.933 0.85 0.84 0.193 0.85 0.84 0.313 SMI 0.83 0.83 0.527 0.84 0.83 0.092 0.84 0.83 0.512 The table also shows that the iAs%, MMA%, and DMA% in urine varied slightly between subjects with abnormal BP (DBP and SBP higher than 90 and 140 mmHg, respectively) and with normal BP (DBP and SBP lower than 90 and 140 mmHg, respectively). Moreover, the iAs%, MMA%, and DMA% in urine were similar between subjects with normal and abnormal PP. The primary and secondary arsenic methylation capacity were slightly higher in subjects with abnormal PP than in those with normal PP, according to the PMI and SMI.
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Figure 1 represents the relationships between blood pressure and cumulative arsenic exposure. The results indicated that positive correlations were observed between CAE and DBP, CAE and SBP, and CAE and PP.
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The ORs for abnormal DBP, SBP, and PP for the concentrations and proportions of urinary arsenic speciation, arsenic methylation capacity, and skin lesion status are listed in Tables 4-6.
Table 4. The relationship between urinary as levels and DBP in study subjects
Variables Crude ORs Adjusted ORs OR 95% CI P OR 95% CI P Gender 1.247 0.816, 1.906 0.307 2.316 1.225, 4.379 0.010 Age 1.075 1.055, 1.095 0.000 1.077 1.054, 1.100 0.000 Smoke 0.665 0.437, 1.013 0.058 1.642 0.916, 2.945 0.096 Alcohol 0.874 0.478, 1.601 0.663 1.430 0.662, 3.088 0.362 BMI 1.162 1.104, 1.223 0.000 1.110 1.054, 1.169 0.000 Skin lesions 1.630 1.082, 2.455 0.019 0.881 0.553, 1.403 0.594 iAs 1.002 0.999, 1.004 0.197 1.002 0.999, 1.005 0.216 MMA 1.002 0.999, 1.005 0.187 1.001 0.997, 1.004 0.761 DMA 1.001 1.000, 1.002 0.077 1.000 0.999, 1.001 0.437 TAs 1.000 1.000, 1.001 0.093 1.000 1.000, 1.001 0.410 iAs% 1.001 0.977, 1.025 0.933 1.033 1.003, 1.064 0.033 MMA% 0.989 0.949, 1.031 0.612 0.960 0.917, 1.006 0.087 DMA% 1.002 0.982, 1.022 0.865 0.989 0.966, 1.013 0.378 PMI 0.999 0.975, 1.023 0.933 0.968 0.940, 0.997 0.030 SMI 1.011 0.979, 1.043 0.516 1.023 0.986, 1.061 0.226 Table 5. The relationship between urinary as levels and SBP in study subjects
Variables Crude ORs Adjusted ORs OR 95% CI P OR 95% CI P Gender 0.607 0.367, 1.002 0.051 0.727 0.346, 0.971 0.400 Age 1.105 1.079, 1.131 0.000 1.107 1.079, 1.136 0.000 Smoke 0.744 0.474, 1.166 0.197 1.328 0.712, 2.477 0.372 Alcohol 1.161 0.584, 2.308 0.096 0.918 0.368, 2.289 0.854 BMI 1.169 1.108, 1.234 0.000 1.117 1.058, 1.179 0.000 Skin lesions 1.774 1.151, 2.735 0.009 0.931 0.563, 1.541 0.781 iAs 1.001 0.998, 1.003 0.668 1.002 0.998, 1.005 0.340 MMA 1.001 0.998, 1.004 0.472 1.000 0.997, 1.004 0.813 DMA 1.001 1.000, 1.001 0.211 1.000 0.999, 1.001 0.724 TAs 1.000 1.000, 1.001 0.295 1.000 1.000, 1.001 0.640 iAs% 0.980 0.953, 1.008 0.164 1.026 0.992, 1.062 0.129 MMA% 0.972 0.930, 1.016 0.214 0.955 0.907, 1.005 0.955 DMA% 1.020 0.997, 1.042 0.085 0.996 0.970, 1.023 0.758 PMI 1.020 0.992, 1.050 0.164 0.974 0.942, 1.008 0.129 SMI 1.030 0.995, 1.067 0.094 1.029 0.988, 1.072 0.167 Table 6. The relationship between urinary as levels and PP in study subjects
Variables Crude ORs Adjusted ORs OR 95% CI P OR 95% CI P Gender 0.327 0.152, 0.703 0.004 0.367 0.139, 0.971 0.044 Age 1.089 1.060, 1.118 0.000 1.084 1.054, 1.116 0.000 Smoke 0.753 0.431, 1.319 0.322 0.824 0.404, 1.679 0.594 Alcohol 2.746 0.835, 9.031 0.096 1.691 0.418, 6.838 0.461 BMI 1.079 1.025, 1.136 0.004 1.039 0.979, 1.104 0.208 Skin lesions 1.046 0.595, 1.837 0.876 0.626 0.334, 1.173 0.144 iAs 1.001 0.997, 1.004 0.612 1.003 0.999, 1.006 0.152 MMA 1.000 0.996, 1.004 0.950 1.000 0.996, 1.005 0.935 DMA 1.000 0.999, 1.001 0.682 1.000 0.999, 1.001 0.964 TAs 1.000 0.999, 1.001 0.705 1.000 1.000, 1.001 0.741 iAs% 0.982 0.947, 1.017 0.313 1.027 0.990, 1.067 0.156 MMA% 0.992 0.938, 1.049 0.781 0.998 0.938, 1.061 0.946 DMA% 0.992 0.938, 1.049 0.781 0.982 0.952, 1.013 0.251 PMI 1.019 0.983, 1.056 0.313 0.973 0.937, 1.010 0.182 SMI 1.014 0.972, 1.059 0.512 0.993 0.946, 1.044 0.793 Table 4 shows that subjects with skin lesions had a higher risk of abnormal DBP than those without skin lesions (OR: 1.630, 95% CI: 1.082, 2.455). After adjusting for gender, age, smoking, alcohol consumption and BMI, the OR was 0.881 (95% CI: 0.553, 1.403). The crude ORs (95% CI) of urinary concentrations of iAs, MMA, DMA, and TAs for the risk of abnormal DBP were 1.002 (0.999, 1.004), 1.002 (0.999, 1.005), 1.001 (1.000, 1.002), and 1.000 (1.000, 1.001), respectively. The P values of the trend were 0.1997, 0.187, 0.077, and 0.093. However, the adjusted ORs were 1.002 (0.999, 1.005), 1.001 (0.997, 1.004), 1.000 (0.997, 1.001), and 1.000 (1.000, 1.001), respectively. Moreover, the risk of abnormal DBP was positively related to iAs% (crude OR: 1.001, adjusted OR: 1.033), DMA% (crude OR: 1.002, adjusted OR: 0.989), and SMI (crude OR: 1.011, adjusted OR: 1.023).
Table 5 presents the ORs of arsenic metabolites for the risk of SBP. The table indicates that positive correlations were observed between SBP and skin lesions (crude OR: 1.774, 95% CI: 1.151, 2.735; adjusted OR: 0.931, 95% CI: 0.563, 1.541), iAs (crude OR: 1.001, 95% CI: 0.998, 1.003; adjusted OR: 1.002, 95% CI: 0.998, 1.005), iAs% (crude OR: 0.980, 95% CI: 0.953, 1.008; adjusted OR: 1.026, 95% CI: 0.996, 1.062), DMA% (crude OR: 1.020, 95% CI: 0.997, 1.042; adjusted OR: 0.996, 95% CI: 0.970, 1.023), PMI (crude OR: 1.020, 95% CI: 0.992, 1.050; adjusted OR: 0.974, 95% CI: 0.942, 1.008), and SMI (crude OR: 1.030, 95% CI: 0.995, 1.067; adjusted OR: 1.029, 95% CI: 0.988, 1.072).
The associations between PP and arsenic metabolites are listed in Table 6. The crude ORs for skin lesions, iAs, iAs%, PMI, and SMI were 1.046 (95% CI: 0.595, 1.837), 1.001 (95% CI: 0.997, 1.004), 0.982 (95% CI: 0.947, 1.017), 1.046 (95% CI: 0.595, 1.837), 1.019 (95% CI: 0.983, 1.056) and 1.014 (95% CI: 0.972, 1.059), while their adjusted ORs were 0.626 (95% CI: 0.334, 1.173), 1.003 (95% CI: 0.999, 1.006), 1.027 (95% CI: 0.990, 1.067), 0.973 (95% CI: 0.595, 1.837), and 0.993 (95% CI: 0.946, 1.044), respectively.
doi: 10.3967/bes2017.044
Blood Pressure Associated with Arsenic Methylation and Arsenic Metabolism Caused by Chronic Exposure to Arsenic in Tube Well Water
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Abstract:
Objective The effects of arsenic exposure from drinking water, arsenic metabolism, and arsenic methylation on blood pressure (BP) were observed in this study. Methods The BP and arsenic species of 560 participants were determined. Logistic regression analysis was applied to estimate the odds ratios of BP associated with arsenic metabolites and arsenic methylation capability. Results BP was positively associated with cumulative arsenic exposure (CAE). Subjects with abnormal diastolic blood pressure (DBP), systolic blood pressure (SBP), and pulse pressure (PP) usually had higher urinary iAs (inorganic arsenic), MMA (monomethylated arsenic), DMA (dimethylated arsenic), and TAs (total arsenic) than subjects with normal DBP, SBP, and PP. The iAs%, MMA%, and DMA% differed slightly between subjects with abnormal BP and those with normal BP. The PMI and SMI were slightly higher in subjects with abnormal PP than in those with normal PP. Conclusion Our findings suggest that higher CAE may elevate BP. Males may have a higher risk of abnormal DBP, whereas females have a higher risk of abnormal SBP and PP. Higher urinary iAs may increase the risk of abnormal BP. Lower PMI may elevate the BP. However, higher SMI may increase the DBP and SBP, and lower SMI may elevate the PP. -
Key words:
- Arsenic /
- Arsenic methylation /
- Arsenic metabolism /
- Blood pressure /
- Drinking water
注释:1) CONFLICT OF INTEREST: -
Table 1. The Characteristics of the Study Subjects
Variables The arsenic levels in drinking water ≤ 10 μg/L 10-100 μg/L 100-300 μg/L > 300 μg/L Age 38.24 39.60 34.69 39.21 Gender Female (n = 399) 79 (69.91%) 127 (83.01%) 115 (64.97%) 78 (66.67) Male (n = 161) 34 (30.09%) 26 (16.99%) 62 (35.03%) 39 (33.33) Smoking Smoker 39 (34.51%) 39 (25.49%) 61 (34.46%) 43 (36.75%) Non-smoker 74 (65.49%) 114 (74.51%) 116 (65.54%) 74 (63.25%) Alcohol Drinker 8 (7.08%) 13 (8.50%) 29 (16.38%) 21 (17.95%) Non-drinker 105 (92.92%) 140 (91.50%) 148 (83.62%) 96 (82.05%) BMI < 18.5 8 (7.08%) 4 (2.62%) 8 (4.52%) 9 (7.69%) 18.5-25 72 (63.72%) 109 (71.24%) 130 (73.45%) 63 (53.85%) > 25 33 (29.20%) 40 (26.14%) 39 (22.03%) 45 (38.46%) Table 2. Blood pressure for the study subject
Items DBP SD SBP SD PP SD Age < 30 76.82 7.67 120.32 9.99 43.52 5.56 30-50 84.91 11.35 129.07 16.06 44.16 8.19 > 50 89.93 14.57 137.64 22.40 48.09 10.93 P (ANOVA) < 0.0001 < 0.0001 < 0.0001 Gender Male 83.49 12.52 128.65 18.22 45.17 8.96 Female 83.66 11.06 127.12 14.28 43.73 6.46 P (t-test) 0.879 0.292 0.034 BMI < 18.5 75.75 9.54 118.82 12.22 43.09 5.26 18.5-25 82.45 11.64 126.74 16.67 44.41 8.21 > 25 89.01 11.83 135.17 17.50 46.19 9.36 P (ANOVA) < 0.0001 < 0.0001 0.025 Smoking Y 85.44 10.90 129.99 15.71 44.79 8.23 N 82.79 12.49 127.51 17.69 44.74 8.38 P (t-test) 0.020 0.126 0.951 Alcohol Y 84.84 9.21 129.10 13.20 44.19 6.90 N 83.37 12.43 128.10 17.63 44.83 8.50 P (t -test) 0.364 0.664 0.568 Skin lesion With 85.28 11.83 129.99 17.75 44.91 9.12 Without 82.75 12.17 127.41 16.88 44.69 7.97 P (t-test) 0.022 0.100 0.773 As content (μg/L) < 10 84.32 11.46 129.12 16.30 44.86 8.02 10-100 85.29 13.35 130.37 18.81 45.09 9.31 100-300 81.51 10.63 125.14 14.26 43.60 6.54 > 300 83.55 12.81 129.14 19.27 45.97 9.51 P (ANOVA) 0.034 0.033 0.105 Table 3. Urinary arsenic metabolites and methyllation capacity index of the subjects
Variables DBP SBP PP > 90 mmHg < 90 mmHg P > 140 mmHg < 140 mmHg P > 55 mmHg < 55 mmHg P iAs 59.32 49.97 0.195 54.80 51.50 0.668 56.48 51.60 0.612 MMA 52.44 44.17 0.210 49.95 45.17 0.472 45.65 46.16 0.950 DMA 228.08 187.55 0.075 221.47 191.04 0.274 208.00 195.56 0.683 TAs 339.44 281.09 0.091 325.76 287.11 0.350 310.12 292.67 0.705 iAs% 15.81 15.74 0.933 14.78 16.00 0.163 14.78 15.88 0.313 MMA% 13.89 14.13 0.613 13.57 14.19 0.214 13.91 14.09 0.781 DMA% 70.30 70.13 0.867 71.65 69.81 0.088 71.30 70.03 0.399 PMI 0.84 0.83 0.933 0.85 0.84 0.193 0.85 0.84 0.313 SMI 0.83 0.83 0.527 0.84 0.83 0.092 0.84 0.83 0.512 Table 4. The relationship between urinary as levels and DBP in study subjects
Variables Crude ORs Adjusted ORs OR 95% CI P OR 95% CI P Gender 1.247 0.816, 1.906 0.307 2.316 1.225, 4.379 0.010 Age 1.075 1.055, 1.095 0.000 1.077 1.054, 1.100 0.000 Smoke 0.665 0.437, 1.013 0.058 1.642 0.916, 2.945 0.096 Alcohol 0.874 0.478, 1.601 0.663 1.430 0.662, 3.088 0.362 BMI 1.162 1.104, 1.223 0.000 1.110 1.054, 1.169 0.000 Skin lesions 1.630 1.082, 2.455 0.019 0.881 0.553, 1.403 0.594 iAs 1.002 0.999, 1.004 0.197 1.002 0.999, 1.005 0.216 MMA 1.002 0.999, 1.005 0.187 1.001 0.997, 1.004 0.761 DMA 1.001 1.000, 1.002 0.077 1.000 0.999, 1.001 0.437 TAs 1.000 1.000, 1.001 0.093 1.000 1.000, 1.001 0.410 iAs% 1.001 0.977, 1.025 0.933 1.033 1.003, 1.064 0.033 MMA% 0.989 0.949, 1.031 0.612 0.960 0.917, 1.006 0.087 DMA% 1.002 0.982, 1.022 0.865 0.989 0.966, 1.013 0.378 PMI 0.999 0.975, 1.023 0.933 0.968 0.940, 0.997 0.030 SMI 1.011 0.979, 1.043 0.516 1.023 0.986, 1.061 0.226 Table 5. The relationship between urinary as levels and SBP in study subjects
Variables Crude ORs Adjusted ORs OR 95% CI P OR 95% CI P Gender 0.607 0.367, 1.002 0.051 0.727 0.346, 0.971 0.400 Age 1.105 1.079, 1.131 0.000 1.107 1.079, 1.136 0.000 Smoke 0.744 0.474, 1.166 0.197 1.328 0.712, 2.477 0.372 Alcohol 1.161 0.584, 2.308 0.096 0.918 0.368, 2.289 0.854 BMI 1.169 1.108, 1.234 0.000 1.117 1.058, 1.179 0.000 Skin lesions 1.774 1.151, 2.735 0.009 0.931 0.563, 1.541 0.781 iAs 1.001 0.998, 1.003 0.668 1.002 0.998, 1.005 0.340 MMA 1.001 0.998, 1.004 0.472 1.000 0.997, 1.004 0.813 DMA 1.001 1.000, 1.001 0.211 1.000 0.999, 1.001 0.724 TAs 1.000 1.000, 1.001 0.295 1.000 1.000, 1.001 0.640 iAs% 0.980 0.953, 1.008 0.164 1.026 0.992, 1.062 0.129 MMA% 0.972 0.930, 1.016 0.214 0.955 0.907, 1.005 0.955 DMA% 1.020 0.997, 1.042 0.085 0.996 0.970, 1.023 0.758 PMI 1.020 0.992, 1.050 0.164 0.974 0.942, 1.008 0.129 SMI 1.030 0.995, 1.067 0.094 1.029 0.988, 1.072 0.167 Table 6. The relationship between urinary as levels and PP in study subjects
Variables Crude ORs Adjusted ORs OR 95% CI P OR 95% CI P Gender 0.327 0.152, 0.703 0.004 0.367 0.139, 0.971 0.044 Age 1.089 1.060, 1.118 0.000 1.084 1.054, 1.116 0.000 Smoke 0.753 0.431, 1.319 0.322 0.824 0.404, 1.679 0.594 Alcohol 2.746 0.835, 9.031 0.096 1.691 0.418, 6.838 0.461 BMI 1.079 1.025, 1.136 0.004 1.039 0.979, 1.104 0.208 Skin lesions 1.046 0.595, 1.837 0.876 0.626 0.334, 1.173 0.144 iAs 1.001 0.997, 1.004 0.612 1.003 0.999, 1.006 0.152 MMA 1.000 0.996, 1.004 0.950 1.000 0.996, 1.005 0.935 DMA 1.000 0.999, 1.001 0.682 1.000 0.999, 1.001 0.964 TAs 1.000 0.999, 1.001 0.705 1.000 1.000, 1.001 0.741 iAs% 0.982 0.947, 1.017 0.313 1.027 0.990, 1.067 0.156 MMA% 0.992 0.938, 1.049 0.781 0.998 0.938, 1.061 0.946 DMA% 0.992 0.938, 1.049 0.781 0.982 0.952, 1.013 0.251 PMI 1.019 0.983, 1.056 0.313 0.973 0.937, 1.010 0.182 SMI 1.014 0.972, 1.059 0.512 0.993 0.946, 1.044 0.793 -
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