Skip to main content
. Author manuscript; available in PMC: 2018 Feb 7.
Published in final edited form as: Curr Environ Health Rep. 2016 Dec;3(4):416–433. doi: 10.1007/s40572-016-0117-9

Table 2.

Studies of antimony exposure biomarkers and atherosclerosis outcomes (4 studies available)

Study,
year		 Population Men
(%)		 Age
Range
(years)		 Biomarker Exposed
vs.
Reference		 Endpoint
Ascertain-
ment		 Outcome (s) No. of
cases /
non-cases		 Relative
Risk estimate (95% CI)		 Adjustment Factors
Cross-sectional studies
Agarwal et al. 2011[57] General US population, NHANES 1999–2006 N=5037 48.3 46.5 (mean)

  • Spot urine (µg/mg)

  • Mean: NR

 Per log µg/mg Self-report

  • Composite prevalence of cardiovascular and cerebrovascular disease

  • 537/4464

  • 2.15 (1.45–3.18)

    (Odds ratio)

 Age, sex, race, education, hypertension, diabetes, hypercholesterolemia, chronic kidney disease, body mass index, C-reactive protein, smoking status, serum cotinine. Sb levels divided by creatinine.
Guo et al. 2016 [19••] General US population, NHANES, 1999–2010 N=1857 49.7 ≥20

  • Spot urine (µg/g)

  • GM: 0.08 µg/g

 Quartiles 1 (≤0.048) vs 2 to 4 (>0.048–0.075, >0.075–0.121, >0.121 µg/g) Self-report

  • Congestive heart failure

  • Coronary heart disease

  • Heart attack

  • Q2 (72/1948)

    Q3 (52/1932)

    Q4 (65/1938)

  • Q2 (70/1948)

    Q3 (92/1933)

    Q4 (77/1939)

  • Q2 (87/1950)

    Q3 (99/1936)

    Q4 (86/1944)

  • 1.69 (1.05, 2.74)

    1.42 (0.79, 2.55)

    2.11 (1.26, 3.55)

    p-trend=0.011

  • 0.82 (0.58, 1.14)

    1.35 (0.95, 1.93)

    1.34 (0.86, 2.08)

    p-trend=0.066

  • 1.37 (0.95, 1.99)

    1.96 (1.37, 2.82)

    1.81 (1.16, 2.83)

    p-trend=0.015

  • (Odds ratio)

 Age, gender, race, smoking, drinking, marital status, education, family poverty-income ratio, BMI, hypertension, diabetes, eGFR, and ln-transformed urinary creatinine. Sb levels also divided by urinary creatinine.
Navas-Acien et al. 2005 [58] General US population, NHANES 1999–2000 N=790 NR ≥40

  • Spot urine (µg/L)

  • (GM=0.11 µg/L)

 75th (0.17 µg/L) vs. 25th (0.07 µg/L) percentile Measured ankle-brachial index<0.9

  • Peripheral arterial disease

  • 49/676

  • 1.15 (0.81–1.63)

    (Odds ratio)

 Age, sex, race, education, smoking, urinary creatinine
Mendy et al. 2012 [20] General US population, NHANES 2007–2008 (N=1857) 49.6 20–80

  • Spot urine (µg/g)

  • GM: 0.06 µg/g

 Above vs. below the GM (0.06 µg/g) Self-report

  • Heart failure

  • Coronary heart disease

  • Heart attack

  • Stroke

  • NR

  • NR

  • NR

  • NR

  • 3.02 (0.96–9.50)

  • 1.48 (0.50–4.38)

  • 1.72 (0.69–4.30)

  • 2.04 (0.87–4.78)

    (Odds ratio)

 Age, sex, race/ethnicity, education level, ratio family income to poverty, alcohol consumption, cigarette smoking, urinary barium, cadmium, cobalt, cesium, molybdenum, lead, thallium, tungsten, and uranium. Sb levels divided by urinary creatinine
Prospective studies
Guo et al. 2016 [19••] General US population, NHANES, 1999–2010N=1857 49.7 ≥20

  • Spot urine (µg/g)

  • GM: 0.08 µg/g

 Quartiles 1 (≤0.048) vs 2 to 4 (>0.048–0.075, >0.075–0.121, >0.121 µg/g) NCHS linkage to National Death Index

  • Heart disease mortality

  • Q2 (22/1952)

    Q3 (47/1938)

    Q4 (49/1954)

  • 1.73 (0.95, 3.14)

    2.18 (1.24, 3.86)

    1.69 (0.85, 3.37)

    p-trend=0.647

    (Hazard ratios)

 Age, gender, race, smoking, drinking, marital status, education, family poverty-income ratio, BMI, hypertension, eGFR, and ln-transformed urinary creatinine. Sb levels also divided by urinary creatinine.

BMI= body mass index; NR: not reported; eGFR: estimated glomerular filtration rate; NCHS: National Center for Health Statistics. GM: geometric mean.