Menke Andy, Muntner Paul, Silbergeld Ellen K, Platz Elizabeth A, Guallar Eliseo
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Environ Health Perspect. 2009 Feb;117(2):190-6. doi: 10.1289/ehp.11236. Epub 2008 Sep 3.
Cadmium exposure has been associated with increased all-cause, cancer, and cardiovascular disease mortality. However, studies investigating this association have included participants with considerably higher levels of cadmium than those found in the general population.
We aimed to evaluate the association of creatinine-corrected urinary cadmium levels with all-cause and cause-specific mortality in the U.S. general population.
We analyzed the relationship between cadmium measured in 13,958 adults who participated in the Third National Health and Nutrition Examination Survey in 1988-1994 and were followed through 31 December 2000, and all-cause, cancer, cardiovascular disease, and coronary heart disease mortality.
The geometric mean levels of urinary cadmium per gram of urinary creatinine in study participants were 0.28 and 0.40 microg/g for men and women, respectively (p < 0.001). After multivariable adjustment, including smoking, a major source of cadmium exposure in nonoccupationally exposed populations, the hazard ratios [95% confidence interval (CI)] for all-cause, cancer, cardiovascular disease, and coronary heart disease mortality associated with a 2-fold higher creatinine-corrected urinary cadmium were, respectively, 1.28 (95% CI, 1.15-1.43), 1.55 (95% CI, 1.21-1.98), 1.21 (95% CI, 1.07-1.36), and 1.36 (95% CI, 1.11-1.66) for men and 1.06 (95% CI, 0.96-1.16), 1.07 (95% CI, 0.85-1.35), 0.93 (95% CI, 0.84-1.04), and 0.82 (95% CI, 0.76-0.89) for women.
Environmental cadmium exposure was associated with an increased risk of all-cause, cancer, and cardiovascular disease mortality among men, but not among women. Additional efforts are warranted to fully explain gender differences on the impact of environmental cadmium exposure.
镉暴露与全因死亡率、癌症死亡率和心血管疾病死亡率升高有关。然而,调查这种关联的研究纳入的参与者镉水平远高于一般人群中的发现。
我们旨在评估美国一般人群中肌酐校正尿镉水平与全因死亡率及特定病因死亡率之间的关联。
我们分析了1988 - 1994年参加第三次全国健康和营养检查调查并随访至2000年12月31日的13958名成年人的镉测量值与全因死亡率、癌症死亡率、心血管疾病死亡率和冠心病死亡率之间的关系。
研究参与者每克尿肌酐中尿镉的几何平均水平,男性为0.28微克/克,女性为0.40微克/克(p < 0.001)。在进行多变量调整后,包括吸烟(非职业暴露人群中镉暴露的主要来源),肌酐校正尿镉水平高出2倍时,男性全因死亡率、癌症死亡率、心血管疾病死亡率和冠心病死亡率的风险比[95%置信区间(CI)]分别为1.28(95% CI,1.15 - 1.43)、1.55(95% CI,1.21 - 1.98)、1.21(95% CI,1.07 - 1.36)和1.36(95% CI,1.11 - 1.66),女性分别为1.06(95% CI,0.96 - 1.16)、1.07(95% CI,0.85 - 1.35)、0.93(95% CI,0.84 - 1.04)和0.82(95% CI,0.76 - 0.89)。
环境镉暴露与男性全因死亡率、癌症死亡率和心血管疾病死亡率风险增加有关,但与女性无关。有必要进一步努力充分解释环境镉暴露影响方面的性别差异。