Table 3 Multivariable-adjusted HRs (95% CIs) of incident components of the metabolic syndrome by quartiles (Q) of toenail chromium levels, the CARDIA study, 1987 to 2010^*.

From: Chromium exposure and incidence of metabolic syndrome among American young adults over a 23-year follow-up: the CARDIA Trace Element Study

	Q1	Q2	Q3	Q4	P for trend^†
Glucose (n = 3,992)
Chromium- ppm	<0.265	0.265–0.549	0.550–1.215	≥1.216
No. of participants	999	997	998	998
No. of events	172	178	157	147
Incidence rate/1000 person years	9.71	9.69	8.51	8.03
Model 1^‡	1 (Referent)	0.97 (0.79–1.20)	0.89 (0.71–1.11)	0.87 (0.70–1.10)	0.269
Model 2^‡	1 (Referent)	0.88 (0.71–1.09)	0.87 (0.70–1.08)	0.85 (0.68–1.07)	0.376
Model 3^§	1 (Referent)	0.91 (0.74–1.13)	0.85 (0.68–1.05)	0.87 (0.69–1.08)	0.395
Blood pressure (n = 3,647)
Chromium- ppm	<0.266	0.266–0.551	0.552–1.232	≥1.233
No. of participants	911	912	913	911
No. of events	364	387	344	351
Incidence rate/1000 person years	23.81	24.91	21.73	21.79
Model 1^‡	1 (Referent)	1.07 (0.92–1.23)	0.99 (0.85–1.15)	1.03 (0.89–1.20)	0.518
Model 2^‡	1 (Referent)	1.03 (0.89–1.19)	0.98 (0.85–1.14)	1.05 (0.90–1.22)	0.750
Model 3^§	1 (Referent)	1.07 (0.93–1.24)	0.96 (0.83–1.12)	1.08 (0.93–1.25)	0.667
Waist circumference (n = 3,536)
Chromium- ppm	<0.263	0.263–0.550	0.551–1.231	≥1.232
No. of participants	884	884	884	884
No. of events	335	363	331	331
Incidence rate/1000 person years	22.78	24.79	21.71	21.78
Model 1^‡	1 (Referent)	1.11 (0.95–1.29)	0.98 (0.84–1.14)	0.98 (0.84–1.15)	0.145
Model 2^‡	1 (Referent)	1.15 (0.99–1.34)	0.98 (0.84–1.14)	0.94 (0.80–1.10)	0.234
Model 3^§	1 (Referent)	1.23 (1.06–1.43)	1.07 (0.92–1.26)	1.09 (0.93–1.28)	0.674
Triglycerides (n = 3,563)
Chromium- ppm	<0.266	0.266–0.553	0.554–1.232	≥1.234
No. of participants	890	891	891	891
No. of events	281	268	255	220
Incidence rate/1000 person years	18.69	17.08	16.08	13.75
Model 1^‡	1 (Referent)	0.94 (0.79–1.11)	0.87 (0.73–1.03)	0.78 (0.65–0.94)	0.029
Model 2^‡	1 (Referent)	0.96 (0.81–1.13)	0.88 (0.74–1.04)	0.79 (0.66–0.95)	0.040
Model 3^§	1 (Referent)	0.97 (0.82–1.14)	0.85 (0.72–1.01)	0.82 (0.68–0.98)	0.045
HDL cholesterol (n = 2,989)
Chromium- ppm	<0.269	0.269–0.561	0.562–1.244	≥1.245
No. of participants	748	746	748	747
No. of events	362	316	329	277
Incidence rate/1000 person years	36.30	28.84	29.62	23.95
Model 1^‡	1 (Referent)	0.83 (0.71–0.97)	0.86 (0.74–0.997)	0.70 (0.60–0.83)	0.004
Model 2^‡	1 (Referent)	0.83 (0.71–0.97)	0.87 (0.74–1.01)	0.70 (0.59–0.82)	0.003
Model 3^§	1 (Referent)	0.84 (0.72–0.98)	0.93 (0.80–1.08)	0.75 (0.64–0.88)	0.030

Abbreviations: CARDIA, Coronary Artery Risk Development in Young Adults; CI, Confidence interval; HDL, high-density lipoprotein; HR, Hazard ratio; Q, quartile.
^*All models were constructed using Cox proportional hazards regression analysis.
^†P for trend was examined by using the continuous variable of toenail chromium levels.
^‡Model 1 and model 2: adjusted for covariates cited in the footnote of Table 2.
^§Model 3: model 2 with additional adjustment for the corresponding individual component at baseline.

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Table 3 Multivariable-adjusted HRs (95% CIs) of incident components of the metabolic syndrome by quartiles (Q) of toenail chromium levels, the CARDIA study, 1987 to 2010^*.

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