Background

Low to moderate acute cadmium exposure has been associated with increased risk of chronic diseases, such as cardiovascular and kidney disease. Little is known about the association between urinary cadmium levels—an indicator of longer-term exposure—and metabolic syndrome (MetS).

Methods

We analysed data from 3982 participants aged 20–<80 years of the National Health and Nutrition Examination Survey 2001–2014. Urinary cadmium levels were measured and adjusted for creatinine using spot urine samples. Cadmium levels were evaluated in quintiles (Q). MetS was defined by National Cholesterol Education Program's Adult Treatment Panel III report criteria. Prevalence odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression accounting for complex survey design, while adjusting for potential confounders and stratifying by sex and smoking status.

Results

In the overall study population, there was a marginal inverse association between urinary cadmium and MetS (adj. OR for Q5 versus Q1: 0.7; 95% CI: 0.5–1.0). Sex stratified models were similar. When examining individual components of MetS, participants with higher levels of urinary cadmium had decreased odds of abdominal obesity (adj. OR for Q5 versus Q1 0.4; 95% CI: 0.3–0.6), but increased odds for low HDL (adj. OR for Q5 versus Q1 2.1; 95% CI: 1.4–3.1). Among current smokers, higher urinary cadmium was associated with increased odds of MetS, hypertension, and low HDL even after accounting for serum cotinine—a marker of smoking intensity.

Conclusions

Higher levels of urinary cadmium, a marker of long term exposure, were not associated with an increased risk of MetS in the overall study population. However, higher urine cadmium was associated with altered MetS components. Current smokers were the most vulnerable group, with higher long-term cadmium exposure being associated with increased risk of MetS, low HDL, and hypertension.

中文翻译：

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美国成年人的尿镉浓度和代谢综合征：2001-2014年美国国家健康和营养调查

背景

低至中度的急性镉暴露与诸如心血管疾病和肾脏疾病等慢性疾病的风险增加相关。关于尿镉水平（长期暴露的指标）与代谢综合征（MetS）之间的关系，人们知之甚少。

方法

我们分析了2001年至2014年美国国家健康和营养考试调查中2098岁至<80岁年龄段的3982名参与者的数据。测量尿镉水平，并使用尿样样本对肌酐进行调整。镉水平以五分位数（Q）进行评估。MetS是由国家胆固醇教育计划的成人治疗小组III报告标准定义的。流行率比（OR）和95％置信区间（CI）使用多变量logistic回归计算复杂的调查设计，同时对潜在的混杂因素进行了调整，并按性别和吸烟状况进行了分层。

结果

在总体研究人群中，尿镉和MetS之间存在边际逆相关（Q5与Q1的比值OR：0.7； 95％CI：0.5-1.0）。性别分层模型相似。在检查MetS的各个组成部分时，尿镉水平较高的参与者发生腹部肥胖的几率降低（Q5与Q1相比为OR； Q1为0.4； 95％CI：0.3-0.6），但低HDL的几率却有所增加（ADOR。 Q5与Q1 2.1； 95％CI：1.4-3.1）。在目前的吸烟者中，即使考虑了血清可替宁（吸烟强度的标志），较高的尿镉含量也会增加MetS，高血压和低HDL的几率。

结论

较高水平的尿镉（长期暴露的标志）与总体研究人群中MetS风险的增加无关。但是，较高的尿镉含量与MetS成分的改变有关。当前的吸烟者是最易受伤害的人群，长期接触较高的镉会增加MetS，低HDL和高血压的风险。