Environmental Lead Exposure Accelerates Progressive Diabetic Nephropathy in Type II Diabetic Patients

Table 4

Longitudinal multivariate analysis of body lead burden and other predictors of progressive change in the estimated glomerular filtration rate (D-GFR), using generalized estimating equations, during the 24-month longitudinal study period (𝑛=89).

Variable	Estimate (interactive effect)*	𝑃 value
Age (each increment of 1 yr)	−0.271	<0.001
Gender (female versus male)	−3.575	<0.001
Smoking (no versus yes)	−0.259	0.813
Body-mass index (each increment of 1 kg/m^2)	0.020	0.852
History of cardiovascular diseases (no versus yes)	−0.375	0.686
MAP (mmHg) (each increment of 1 mmHg)	−0.054	0.033
Cholesterol (mg/dL) (each increment of 1 mg/dL)	−0.002	0.811
Triglycerides (mg/dL) (each increment of 1 mg/dL)	−0.004	0.075
HbA1c (%) (each increment of 1%)	0.013	0.793
Serum creatinine (mg/dL) (each increment of 1 mg/dL)	−6.997	<0.001
Body lead burden (μg) (each increment of 1 𝜇g)	−0.022	0.009
Daily protein intake (g/kg) (each increment of 1 g/kg)	1.287	0.460
Daily protein excretion (g) (each increment of 1 g)	−0.417	0.035

The interactive effect of variables was calculated by a generalized estimating equation. Negative values for the interactive effect indicate a decline in the glomerular filtration rate, and positive values indicate an increase. Cardiovascular diseases included ischemic heart disease, congestive heart failure, stroke, and diabetic foot. MAP: mean arterial pressure.