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Long-term cadmium exposure and fractures, cardiovascular disease, and mortality in a prospective cohort of women
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Highlights Cadmium exposure is a toxic metal with multiple health hazards. Present health-based guidance values are limited to renal toxicity. Urinary cadmium was associated with increased risk of fractures and all-cause mortality. These associations were observed at lower expoure levels than current health-based guidance values.
Abstract Background Cadmium (Cd) is a toxic metal, which the non-smoking population is mainly exposed to through diet. Current health-based guidance values are based on renal toxicity; however, emerging evidence suggests that bone and the cardiovascular system might be more sensitive to Cd exposure. Objective To assess the association of urinary Cd (U-Cd) with incidence of fractures, myocardial infarction, heart failure, ischemic stroke and mortality in postmenopausal women. Methods We used data from 4024 women, aged 56–85 in the population-based prospective Swedish Mammography Cohort-Clinical. U-Cd was measured by ICP-MS at baseline (2004–2009) and categorized into tertiles. Incident cases of the outcomes were ascertained via register linkage through 2019. Multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression. Results The median U-Cd at baseline was 0.33 µg/g creatinine (cr) (5–95 percentiles 0.15–0.77). We ascertained the following incident cases: 903 first fracture of any type, 149 myocardial infarction, 174 heart failure, 162 ischemic stroke and 545 total deaths during the approximately 11 years of follow-up. U-Cd was dose-dependently associated with risk of any fracture (HR: 1.20, 95% CI: 1.01 to 1.43, ptrend: 0.04) and all-cause mortality (HR: 1.38, 95% CI: 1.10 to 1.74, ptrend: <0.01) when comparing the highest tertile of U-Cd (median 0.54 µg/g cr) with the lowest (median 0.20 µg/g cr). No clear associations were observed for myocardial infarction, heart failure or stroke. Discussion Long-term Cd exposure might be associated with risk of fractures and all-cause mortality at lower levels than previously suggested.
Long-term cadmium exposure and fractures, cardiovascular disease, and mortality in a prospective cohort of women
Graphical abstract Display Omitted
Highlights Cadmium exposure is a toxic metal with multiple health hazards. Present health-based guidance values are limited to renal toxicity. Urinary cadmium was associated with increased risk of fractures and all-cause mortality. These associations were observed at lower expoure levels than current health-based guidance values.
Abstract Background Cadmium (Cd) is a toxic metal, which the non-smoking population is mainly exposed to through diet. Current health-based guidance values are based on renal toxicity; however, emerging evidence suggests that bone and the cardiovascular system might be more sensitive to Cd exposure. Objective To assess the association of urinary Cd (U-Cd) with incidence of fractures, myocardial infarction, heart failure, ischemic stroke and mortality in postmenopausal women. Methods We used data from 4024 women, aged 56–85 in the population-based prospective Swedish Mammography Cohort-Clinical. U-Cd was measured by ICP-MS at baseline (2004–2009) and categorized into tertiles. Incident cases of the outcomes were ascertained via register linkage through 2019. Multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression. Results The median U-Cd at baseline was 0.33 µg/g creatinine (cr) (5–95 percentiles 0.15–0.77). We ascertained the following incident cases: 903 first fracture of any type, 149 myocardial infarction, 174 heart failure, 162 ischemic stroke and 545 total deaths during the approximately 11 years of follow-up. U-Cd was dose-dependently associated with risk of any fracture (HR: 1.20, 95% CI: 1.01 to 1.43, ptrend: 0.04) and all-cause mortality (HR: 1.38, 95% CI: 1.10 to 1.74, ptrend: <0.01) when comparing the highest tertile of U-Cd (median 0.54 µg/g cr) with the lowest (median 0.20 µg/g cr). No clear associations were observed for myocardial infarction, heart failure or stroke. Discussion Long-term Cd exposure might be associated with risk of fractures and all-cause mortality at lower levels than previously suggested.
Long-term cadmium exposure and fractures, cardiovascular disease, and mortality in a prospective cohort of women
Tägt, Jonas (author) / Helte, Emilie (author) / Donat-Vargas, Carolina (author) / Larsson, Susanna C (author) / Michaëlsson, Karl (author) / Wolk, Alicja (author) / Vahter, Marie (author) / Kippler, Maria (author) / Åkesson, Agneta (author)
2022-01-23
Article (Journal)
Electronic Resource
English
B-Cd , Blood Cadmium , BMD , Bone Mineral Density , CABG , Coronary Artery Bypass Grafting , Cd , Cadmium , CI , Confidence Interval , cr , Creatinine , CV , Coefficient of Variation , CVD , Cardiovascular disease , EFSA , European Food Safety Authority , eGFR , estimated Glomerular Filtration Rate , HR , Hazard Ratio , ICD-10 , International Classification of Disease 10th revision codes , ICP-MS , Inductively Coupled Plasma Mass Spectrometry , LDL , Low-density Lipoprotein , LOD , Limit of Detection , NPR , National Patient Register , PCI , Percutaneous Coronary Intervention , SD , Standard Deviation , SMC , Swedish Mammography Cohort , SMC-C , Swedish Mammography Cohort Clinical , U-Cd , Urinary Cadmium , Fractures , Mortality
Long-term exposure to ozone and cardiovascular mortality in a large Chinese cohort
| DOAJ | 2022