Environmental Lead Exposure Accelerates Progressive Diabetic Nephropathy in Type II Diabetic Patients
Table 5
Longitudinal multivariate analysis of blood lead level 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 ().
Variable
Estimate (interactive effect)*
value
Age (each increment of 1 yr)
−0.268
<0.001
Gender (female versus male)
−3.261
<0.001
Smoking (no versus yes)
−0.631
0.604
Body-mass index (each increment of 1 kg/m2)
−0.018
0.861
Previous cardiovascular diseases (no versus yes)
−0.220
0.818
MAP (mmHg) (each increment of 1 mmHg)
0.025
Cholesterol (mg/dL) (each increment of 1 mg/dL)
−0.006
0.406
Triglycerides (mg/dL) (each increment of 1 mg/dL)
0.024
HbA1c (%) (each increment of 1%)
−0.002
0.976
Serum creatinine (mg/dL) (each increment of 1 mg/dL)
−7.550
<0.001
Blood lead level (μg/dL) (each increment of 1 μg/dL)
−0.298
0.010
Daily protein intake (g/kg) (each increment of 1 g/kg)
1.143
0.539
Daily protein excretion (g) (each increment of 1 g)
−0.400
0.045
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.
