Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Epidemiology. 2013 May;24(3):421-9. doi: 10.1097/EDE.0b013e31828b0631.
Cadmium is a widespread toxic metal with potential cardiovascular effects, but no studies have evaluated cadmium and incident cardiovascular disease. We evaluated the association of urine cadmium concentration with cardiovascular disease incidence and mortality in a large population-based cohort.
We conducted a prospective cohort study of 3348 American Indian adults 45-74 years of age from Arizona, Oklahoma, and North and South Dakota, who participated in the Strong Heart Study in 1989-1991. Urine cadmium was measured using inductively coupled plasma mass spectrometry. Follow-up extended through 31 December 2008.
The geometric mean cadmium level in the study population was 0.94 μg/g (95% confidence interval [CI] = 0.92-0.96). We identified 1084 cardiovascular events, including 400 deaths. After adjustment for sociodemographic and cardiovascular risk factors, the hazard ratios (HRs) (comparing the 80th to the 20th percentile of urine cadmium concentrations) was 1.43 for cardiovascular mortality (95% CI = 1.21-1.70) and 1.34 for coronary heart disease mortality (1.10-1.63). The corresponding HRs for incident cardiovascular disease, coronary heart disease, stroke, and heart failure were 1.24 (1.11-1.38), 1.22 (1.08-1.38), 1.75 (1.17-2.59), and 1.39 (1.01-1.94), respectively. The associations were similar in most study subgroups, including never-smokers.
Urine cadmium, a biomarker of long-term exposure, was associated with increased cardiovascular mortality and increased incidence of cardiovascular disease. These findings support that cadmium exposure is a cardiovascular risk factor.
镉是一种广泛存在的有毒金属，具有潜在的心血管效应，但尚无研究评估过镉与心血管疾病的关系。我们评估了尿液镉浓度与大型基于人群队列的心血管疾病发病率和死亡率之间的关联。
我们对来自亚利桑那州、俄克拉荷马州、北达科他州和南达科他州的 3348 名年龄在 45-74 岁的美国印第安成年人进行了一项前瞻性队列研究，他们参加了 1989-1991 年的“强健心脏研究”。采用电感耦合等离子体质谱法测定尿液中的镉含量。随访时间截止到 2008 年 12 月 31 日。
研究人群中镉的几何平均值为 0.94μg/g（95%置信区间[CI]：0.92-0.96）。我们发现 1084 例心血管事件，包括 400 例死亡。在校正了社会人口统计学和心血管危险因素后，尿液镉浓度第 80 百分位数与第 20 百分位相比，心血管死亡率的危险比（HR）为 1.43（95%CI：1.21-1.70），冠心病死亡率的 HR 为 1.34（1.10-1.63）。新发心血管疾病、冠心病、卒中和心力衰竭的相应 HR 分别为 1.24（1.11-1.38）、1.22（1.08-1.38）、1.75（1.17-2.59）和 1.39（1.01-1.94）。这些关联在大多数研究亚组中均相似，包括从不吸烟的人群。
尿液镉作为长期暴露的生物标志物，与心血管死亡率增加和心血管疾病发病率增加相关。这些发现支持镉暴露是心血管危险因素。
