{"id":"https://openalex.org/W1970306362","doi":"https://doi.org/10.1097/00001648-200407000-00378","title":"LOW-LEVEL LEAD EXPOSURE, DIABETES, AND HEART RATE VARIABILITY: THE VA NORMATIVE AGING STUDY","display_name":"LOW-LEVEL LEAD EXPOSURE, DIABETES, AND HEART RATE VARIABILITY: THE VA NORMATIVE AGING STUDY","publication_year":2004,"publication_date":"2004-07-01","ids":{"openalex":"https://openalex.org/W1970306362","doi":"https://doi.org/10.1097/00001648-200407000-00378","mag":"1970306362"},"language":"en","primary_location":{"id":"doi:10.1097/00001648-200407000-00378","doi":"https://doi.org/10.1097/00001648-200407000-00378","is_oa":false,"landing_page_url":"https://doi.org/10.1097/00001648-200407000-00378","pdf_url":null,"source":{"id":"https://openalex.org/S15470582","display_name":"Epidemiology","issn_l":"1044-3983","issn":["1044-3983","1531-5487"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Epidemiology","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5065187501","display_name":"Sung Kyun Park","orcid":"https://orcid.org/0000-0001-9981-6250","observed_orcids":["https://orcid.org/0000-0001-9981-6250"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Sung Kyun Park","raw_affiliation_strings":["Harvard School of Public Health"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Harvard School of Public Health","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5046557560","display_name":"Joel David Schwartz","orcid":"https://orcid.org/0000-0001-6168-378X","observed_orcids":["https://orcid.org/0000-0001-6168-378X","https://orcid.org/0000-0001-5232-9957"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Joel Schwartz","raw_affiliation_strings":["Harvard School of Public Health"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Harvard School of Public Health","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5086410623","display_name":"Marc G. Weisskopf","orcid":"https://orcid.org/0000-0003-4513-9834","observed_orcids":["https://orcid.org/0000-0003-4513-9834"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Marc Weisskopf","raw_affiliation_strings":["Harvard School of Public Health"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Harvard School of Public Health","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5077227129","display_name":"David Sparrow","orcid":"https://orcid.org/0000-0001-8396-1584","observed_orcids":["https://orcid.org/0000-0001-8396-1584"]},"institutions":[{"id":"https://openalex.org/I1322918889","display_name":"United States Department of Veterans Affairs","ror":"https://ror.org/05rsv9s98","country_code":"US","type":"government","lineage":["https://openalex.org/I1322918889"]},{"id":"https://openalex.org/I2799886695","display_name":"Veterans Health Administration","ror":"https://ror.org/05eq41471","country_code":"US","type":"government","lineage":["https://openalex.org/I1322918889","https://openalex.org/I2799886695"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"David Sparrow","raw_affiliation_strings":["The Normative Aging Study, Department of Veterans Affairs Medical"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Normative Aging Study, Department of Veterans Affairs Medical","institution_ids":["https://openalex.org/I1322918889","https://openalex.org/I2799886695"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5033355210","display_name":"Pantel Vokonas","orcid":"https://orcid.org/0000-0002-3639-035X","observed_orcids":["https://orcid.org/0000-0002-3639-035X"]},"institutions":[{"id":"https://openalex.org/I1322918889","display_name":"United States Department of Veterans Affairs","ror":"https://ror.org/05rsv9s98","country_code":"US","type":"government","lineage":["https://openalex.org/I1322918889"]},{"id":"https://openalex.org/I2799886695","display_name":"Veterans Health Administration","ror":"https://ror.org/05eq41471","country_code":"US","type":"government","lineage":["https://openalex.org/I1322918889","https://openalex.org/I2799886695"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Pantel Vokonas","raw_affiliation_strings":["The Normative Aging Study, Department of Veterans Affairs Medical"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Normative Aging Study, Department of Veterans Affairs Medical","institution_ids":["https://openalex.org/I1322918889","https://openalex.org/I2799886695"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5078987114","display_name":"Howard Hu","orcid":"https://orcid.org/0000-0002-3676-2707","observed_orcids":["https://orcid.org/0000-0002-3676-2707"]},"institutions":[{"id":"https://openalex.org/I1283280774","display_name":"Brigham and Women's Hospital","ror":"https://ror.org/04b6nzv94","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I121934306","https://openalex.org/I1283280774","https://openalex.org/I48633490"]},{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Howard Hu","raw_affiliation_strings":["Brigham and Women's Hospital","Channing Laboratory","Harvard Medical School","Harvard School of Public Health"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Brigham and Women's Hospital","institution_ids":["https://openalex.org/I1283280774"]},{"raw_affiliation_string":"Channing Laboratory","institution_ids":[]},{"raw_affiliation_string":"Harvard Medical School","institution_ids":["https://openalex.org/I136199984"]},{"raw_affiliation_string":"Harvard School of Public Health","institution_ids":["https://openalex.org/I136199984"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5046557560","https://openalex.org/A5065187501","https://openalex.org/A5078987114","https://openalex.org/A5086410623"],"corresponding_institution_ids":["https://openalex.org/I1283280774","https://openalex.org/I136199984"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.14685004,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"15","issue":"4","first_page":"S145","last_page":"S145"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10790","display_name":"Heavy Metal Exposure and Toxicity","score":0.9394999742507935,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T10790","display_name":"Heavy Metal Exposure and Toxicity","score":0.9394999742507935,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T10745","display_name":"Heart Rate Variability and Autonomic Control","score":0.05550000071525574,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12269","display_name":"Effects of Vibration on Health","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/low-level-lead-exposure","display_name":"low-level lead exposure","score":0.8709999918937683},{"id":"https://openalex.org/keywords/heart-rate-variability","display_name":"heart rate variability","score":0.9869999885559082},{"id":"https://openalex.org/keywords/diabetes-mellitus","display_name":"diabetes mellitus","score":0.9940000176429749},{"id":"https://openalex.org/keywords/cardiac-autonomic-function","display_name":"cardiac autonomic function","score":0.8529999852180481},{"id":"https://openalex.org/keywords/vagal-tone","display_name":"vagal tone","score":0.7889999747276306},{"id":"https://openalex.org/keywords/sympathovagal-balance","display_name":"sympathovagal balance","score":0.8579999804496765},{"id":"https://openalex.org/keywords/lf-hf-ratio","display_name":"LF/HF ratio","score":0.949999988079071},{"id":"https://openalex.org/keywords/patella-lead","display_name":"patella lead","score":0.7879999876022339},{"id":"https://openalex.org/keywords/tibia-lead","display_name":"tibia lead","score":0.9940000176429749},{"id":"https://openalex.org/keywords/bone-lead","display_name":"bone lead","score":0.6769999861717224},{"id":"https://openalex.org/keywords/blood-lead-levels","display_name":"blood lead levels","score":0.9679999947547913},{"id":"https://openalex.org/keywords/normative-aging-study","display_name":"Normative Aging Study","score":0.7540000081062317},{"id":"https://openalex.org/keywords/older-men","display_name":"older men","score":0.847000002861023},{"id":"https://openalex.org/keywords/community-dwelling-individuals","display_name":"community residents","score":0.47200000286102295},{"id":"https://openalex.org/keywords/cardiovascular-risk","display_name":"cardiovascular risk","score":0.3190000057220459},{"id":"https://openalex.org/keywords/sudden-cardiac-death","display_name":"sudden cardiac death","score":0.6150000095367432},{"id":"https://openalex.org/keywords/heart-failure","display_name":"heart failure","score":0.8220000267028809},{"id":"https://openalex.org/keywords/sex-differences","display_name":"sex differences","score":0.3370000123977661}],"concepts":[{"id":"https://openalex.org/C71635504","wikidata":"https://www.wikidata.org/wiki/Q933954","display_name":"Heart rate variability","level":4,"score":0.8325650095939636},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7630979418754578},{"id":"https://openalex.org/C555293320","wikidata":"https://www.wikidata.org/wiki/Q12206","display_name":"Diabetes mellitus","level":2,"score":0.7280890941619873},{"id":"https://openalex.org/C77350462","wikidata":"https://www.wikidata.org/wiki/Q1125472","display_name":"Confounding","level":2,"score":0.6370182037353516},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.6126654744148254},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.5332562327384949},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.46277937293052673},{"id":"https://openalex.org/C2777953023","wikidata":"https://www.wikidata.org/wiki/Q1073121","display_name":"Heart rate","level":3,"score":0.4473803639411926},{"id":"https://openalex.org/C84393581","wikidata":"https://www.wikidata.org/wiki/Q82642","display_name":"Blood pressure","level":2,"score":0.42844870686531067},{"id":"https://openalex.org/C2777093003","wikidata":"https://www.wikidata.org/wiki/Q6508345","display_name":"Lead (geology)","level":2,"score":0.4181615114212036},{"id":"https://openalex.org/C42407357","wikidata":"https://www.wikidata.org/wiki/Q521","display_name":"Physiology","level":1,"score":0.3565205931663513},{"id":"https://openalex.org/C134018914","wikidata":"https://www.wikidata.org/wiki/Q162606","display_name":"Endocrinology","level":1,"score":0.3460680842399597},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.09496983885765076},{"id":"https://openalex.org/C127313418","wikidata":"https://www.wikidata.org/wiki/Q1069","display_name":"Geology","level":0,"score":0.0},{"id":"https://openalex.org/C114793014","wikidata":"https://www.wikidata.org/wiki/Q52109","display_name":"Geomorphology","level":1,"score":0.0}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1097/00001648-200407000-00378","doi":"https://doi.org/10.1097/00001648-200407000-00378","is_oa":false,"landing_page_url":"https://doi.org/10.1097/00001648-200407000-00378","pdf_url":null,"source":{"id":"https://openalex.org/S15470582","display_name":"Epidemiology","issn_l":"1044-3983","issn":["1044-3983","1531-5487"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Epidemiology","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7097152611","https://openalex.org/W2133236243","https://openalex.org/W4282923156","https://openalex.org/W2440147419","https://openalex.org/W2916776684","https://openalex.org/W2115625656","https://openalex.org/W2479733347","https://openalex.org/W2944438511","https://openalex.org/W3016645727","https://openalex.org/W7202092664"],"abstract_inverted_index":{"ISEE-355":[0],"Abstract:":[1],"Decreased":[2],"heart":[3,22],"rate":[4],"variability":[5],"(HRV),":[6],"a":[7,29,82,106,280,297,356],"marker":[8],"of":[9,54,66,88,109,116,161,168,171,247,290,344,375],"poor":[10],"cardiac":[11,19],"autonomic":[12],"function,":[13],"has":[14,47],"been":[15,48],"associated":[16,73,256,278,341],"with":[17,41,74,120,257,279,323,330,342],"sudden":[18],"death":[20],"and":[21,77,103,144,187,195,245,296,313,378],"failure.":[23],"Several":[24],"observational":[25],"studies":[26,67],"have":[27,68],"shown":[28,69],"significantly":[30],"decreased":[31],"vagal":[32],"tone":[33],"in":[34,60,98,105,180,259,271,294,305,309],"workers":[35],"occupationally":[36],"exposed":[37],"to":[38,50,92,139,150,184,192,288,303,328,362],"lead,":[39,332],"compared":[40],"non-exposed":[42],"controls.":[43],"However,":[44,263],"no":[45,252],"study":[46,90],"conducted":[49],"evaluate":[51],"the":[52,61,94,114,131,158,165,169,172,260,291,345,376],"effects":[53],"non-occupational":[55],"lead":[56,101,118,142,153,253,273,325,337,367],"exposure":[57,119],"on":[58],"HRV":[59,121,155,204,346],"general":[62],"population.":[63],"A":[64],"number":[65],"that":[70,267,352,358],"diabetes":[71,104,226],"is":[72,359],"reduced":[75],"HRV,":[76,99],"thus":[78],"diabetics":[79,312,353],"may":[80,354],"represent":[81],"more":[83],"vulnerable":[84],"subpopulation.":[85],"The":[86,307,321,349],"purpose":[87],"this":[89],"was":[91,213,255,277,315],"examine":[93],"relationship":[95],"between":[96,175,311],"alterations":[97],"low-level":[100,117,366],"exposure,":[102,368],"large":[107],"group":[108],"community":[110],"residents.":[111],"We":[112,135],"examined":[113],"association":[115],"measures":[122,205,347],"among":[123],"385":[124],"male":[125],"participants":[126],"(mean":[127],"age":[128],"73)":[129],"from":[130],"Normative":[132],"Aging":[133],"Study.":[134],"used":[136,207],"K-x-ray":[137],"fluorescence":[138],"measure":[140,151],"bone":[141],"levels,":[143],"graphite":[145],"furnace":[146],"atomic":[147],"absorption":[148],"spectroscopy":[149],"blood":[152,217,236,239],"levels.":[154],"variables":[156],"included":[157],"standard":[159],"deviation":[160],"normal-to-normal":[162],"(NN)":[163],"intervals,":[164,178],"square":[166],"root":[167],"mean":[170],"squared":[173],"differences":[174],"adjacent":[176],"NN":[177],"power":[179],"high":[181],"(HF,":[182],"0.15":[183,193],"0.40":[185],"Hz)":[186],"low":[188],"frequency":[189],"(LF,":[190],"0.04":[191],"Hz),":[194],"LF/HF":[196,292],"ratio,":[197],"reflecting":[198],"sympathovagal":[199],"balance.":[200],"Log":[201],"10":[202],"transformed":[203],"were":[206,326,339],"as":[208,215],"response":[209],"variables.":[210],"Diabetes":[211],"mellitus":[212],"defined":[214],"fasting":[216,238],"glucose":[218],"levels":[219,338],"greater":[220],"than":[221],"126":[222],"mg/dL":[223],"and/or":[224],"physician-diagnosed":[225],"(n=77,":[227],"20%).":[228],"After":[229],"controlling":[230],"for":[231,318],"potential":[232],"confounders":[233],"(age,":[234],"diastolic":[235],"pressure,":[237],"glucose,":[240],"cigarette":[241],"smoking,":[242],"serum":[243],"cholesterol,":[244],"use":[246],"angiotensin":[248],"converting":[249],"enzyme":[250],"inhibitor),":[251],"biomarker":[254],"HRVs":[258],"entire":[261],"cohort.":[262],"stratified":[264],"analyses":[265],"showed":[266],"an":[268,372],"interquartile":[269],"increase":[270,282],"patella":[272,331],"(20":[274],"micro":[275],"gram/gram)":[276],"22.8%":[281],"(95%":[283,300],"confidence":[284],"interval":[285],"(CI),":[286],"\u22124.5%":[287],"78.9%)":[289],"ratio":[293],"diabetics,":[295],"7.4%":[298],"decrease":[299],"CI,":[301],"+18.3%":[302],"4.8%)":[304],"non-diabetics.":[306],"difference":[308],"effect":[310],"non-diabetics":[314],"significant":[316],"(p=0.04":[317],"interaction":[319],"term).":[320],"associations":[322],"tibia":[324],"similar":[327],"those":[329],"but":[333],"less":[334],"significant.":[335],"Blood":[336],"not":[340],"any":[343],"examined.":[348],"results":[350],"suggest":[351],"be":[355],"population":[357],"particularly":[360],"susceptible":[361],"cardiovascular":[363],"damage":[364],"by":[365,371],"mainly":[369],"explained":[370],"altered":[373],"balance":[374],"parasympathetic":[377],"sympathetic":[379],"nerve":[380],"activities.":[381]},"counts_by_year":[],"updated_date":"2026-11-05T12:25:35.769452","created_date":"2016-06-24T00:00:00"}
