Air Quality Criteria for Lead Volume II of II - (NEPIS)(EPA) - US ...

AX6-73
Table AX6-4.1 (cont’d). Renal Effects of Lead in the General Population
Reference, Study
Location, and
Period Study Description Pb Measurement Findings, Interpretation
United States (cont’d)
Tsaih et al. (2004)
Boston, MA
1991-~2001
448 men enrolled in the Normative Aging Study.
Baseline Serum Creatinine
1.3 mg/dL
Longitudinal analysis of data from 2 evaluations a
mean of 6 yrs apart.
Annual change in serum creatinine = (follow-up
serum creatinine – baseline serum creatinine) / yrs of
follow-up.
Covariates assessed = age, age squared, body mass
index, hypertension (defined as blood pressure ∃160
or 95 mm Hg or physician diagnosis with use of
antihypertensive medication), diabetes (defined as use
of oral hypoglycemic drugs or insulin or reported
physician diagnosis), smoking status, alcohol
consumption, analgesic use, and, in longitudinal
models, baseline serum creatinine and its square.
Six percent and 26% of subjects had diabetes and
hypertension, at baseline, respectively.
Mean (SD) baseline blood Pb
6.5 (4.2) µg/dL
Mean (SD) baseline tibia Pb
21.5 (13.5) µg/g bone mineral
Mean (SD) baseline patella Pb
32.4 (20.5) µg/g
Mean blood Pb levels and serum creatinine decreased
significantly over the follow-up period in the group. Pb
dose not associated with change in creatinine overall.
Significant interaction of blood and tibia Pb with diabetes
in predicting annual change in serum creatinine.
∃ (95% CI) for natural ln baseline blood Pb 0.076 (0.031,
0.121) compared to 0.006 (!0.004, 0.016) for nondiabetics.
∃ (95% CI) for natural ln baseline tibia Pb 0.082 (0.029,
0.135) compared to 0.005 (!0.005, 0.015) for nondiabetics.
Significant interaction of tibia Pb with hypertensive status
in predicting annual change in serum creatinine.
∃ (95% CI) for natural ln baseline tibia Pb 0.023 (0.003,
0.019) compared to 0.0004 (!0.001, 0.002) for nonhypertensives.
Follow-up serum creatinine was also modeled separately
in longitudinal analyses; diabetes modified the association
between baseline tibia Pb and follow-up serum creatinine.