Table 3.

Hazard Ratios^a for Incident Peripheral Arterial Disease (Defined as Either ABI <0.9 or ABI >1.4) Among Participants in the Strong Heart Study, Comparing the 80th Percentiles of Arsenic Metabolism Biomarkers With the 20th Percentiles, 1989–1999

Modeling Approach and Biomarker	iAs%		MMA%		DMA%
	HR	95% CI	HR	95% CI	HR	95% CI
ABI <0.9
Standard approach	0.97	0.73, 1.21	0.78	0.60, 1.08	1.19	0.81, 1.63
Leave-one-out approach
iAs%b			0.69	0.42, 1.28	0.85	0.49, 1.54
MMA%c	1.16	0.76, 1.56			1.35	0.79, 1.98
DMA%d	1.03	0.76, 1.31	0.76	0.57, 1.07
ABI >1.4
Standard approach	0.89	0.67, 1.19	0.65	0.49, 0.93	1.46	0.99, 1.97
Leave-one-out approach
iAs%			0.59	0.34, 1.10	0.93	0.50, 1.70
MMA%	1.54	0.83, 2.50			2.23	1.10, 3.72
DMA%	1.06	0.74, 1.46	0.62	0.45, 0.92

Abbreviations: ABI, ankle brachial index; CI, confidence interval; DMA, dimethylarsinous acid; HR, hazard ratio; iAs, inorganic arsenic, MMA, monomethylarsonous acid.

^a The model adjusted for sex, age, education, smoking, body mass index, low-density lipoprotein cholesterol, diabetes, hypertension, estimated glomerular filtration rate, study center, and the sum of inorganic and methylated arsenic species.

^b The model further adjusted for DMA% or MMA%.

^c The model further adjusted for DMA% or iAs%.

^d The model further adjusted for MMA% or iAs%.