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Methodological issues related to studies of lead mobilization during menopause Consideraciones metodológicas relacionadas con estudios sobre movilización de plomo durante la menopausia

By Gertrud S. Berkowitz, Jacqueline M. Moline and Andrew C. Todd

Abstract

While there has been a substantial decline in lead exposure in the United States during the past two decades, mobilization of existing lead stored in bone potentially represents an important endogenous source of exposure for menopausal women. It has been hypothesized that lead may be mobilized from skeletal stores during conditions of high bone turnover, such as during menopause. However, such mobilization has not been documented in prospective studies. This discussion is focussed on some of the methodological difficulties to be anticipated in longitudinal studies of lead mobilization specific to menopause and the issues that need to be taken into account when evaluating the results of such studies. To evaluate whether lead mobilization occurs during menopause, a prospective repeated measures design is needed using X-ray fluorescence analysis of lead in bone and serial measurements of blood lead. Potential confounders and effect modifiers also need to be taken into account in the statistical analysis.<br>Mientras que la exposición a plomo ha declinado sustancialmente en Estados Unidos durante las dos décadas pasadas, la mobilización del plomo almacenado en los huesos representa potencialmente una importante fuente de exposición endógena en mujeres menopáusicas. No obstante, tal movilización no ha sido documentada por estudios prospectivos. La presente discusión se enfoca en algunas de las dificultades metodológicas a se anticipadas en estudios longitudinales de mobilización de plomo específicamente en la menopausia, y los aspectos que necesitan ser considerados cuando se evalúan los resultados de tales estudios. Para evaluar si durante la menopausia el plomo es mobilizado, se requiere de un diseño prospectivo con mediciones repetidas utilizando análisis de fluorescencia de rayos-X para determinar el plomo en hueso y una serie de mediciones de plomo en sangre. Los potenciales confusores y modificadores del efecto también deben tomarse en cuenta en el análisis estadístico

Topics: plomo, menopausia, estrógenos, lead, menopause, estrogens, LCC:Medicine (General), LCC:R5-920, LCC:Medicine, LCC:R, DOAJ:Medicine (General), DOAJ:Health Sciences
Publisher: Instituto Nacional de Salud Pública
Year: 1999
OAI identifier: oai:doaj.org/article:ed99a259f5fd48c7b0e01f80fcb83351
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