Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubation), Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubation), Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Sci Total Environ. 2018 Dec 1;643:270-276. doi: 10.1016/j.scitotenv.2018.06.105. Epub 2018 Jun 22.
Inconsistencies are noted regarding the association between cadmium exposure and blood pressure/hypertension and the interaction between cadmium and body mass index (BMI). This study aims to clarify these inconsistencies in a large sample (n = 32,791) of adults age ≥20 years from eight cycles of the US National Health Examination and Nutrition Survey (NHANES, 1999-2014). The cadmium levels in blood (BCd) and urine (UCd) were used as exposure biomarker. Multiple-linear/logistic regression models were built and stratified by sex, ethnicity and BMI category. The interaction between BCd and BMI was assessed on additive and multiplicative scales. A twofold increase in BCd was associated with 0.54 mm Hg (95% CI: 0.49, 0.58) and 0.05 mm Hg (95% CI: 0.04, 0.06) increases in the systolic blood pressure (SBP) and diastolic blood pressure (DBP), respectively, in black women. The SBP and DBP increased by 0.92 mm Hg (95% CI: 0.73, 1.11) and 0.85 mm Hg (95% CI: 0.65, 1.05), respectively, in Mexican-Am women. Significant associations were found between BCd and hypertension in them (systolic risk per twofold BCd, OR = 1.31; 95% CI: 1.07, 1.61; and diastolic risk per twofold BCd, OR = 1.55; 95% CI: 1.17, 2.05). UCd was significantly associated with hypertension in all individuals (OR = 1.14 per twofold; 95% CI: 1.07, 1.21). The associations between cadmium exposure and blood pressure/hypertension showed some discrepancies across BMI categories. A negative interaction was observed between BCd and obesity with regard to their effects on systolic hypertension (RERI = -0.30; 95% CI: -0.56, -0.03; ratio of ORs = 0.55; 95% CI: 0.35, 0.89). Our findings provided evidence for the effect of cadmium on blood pressure and the prevalence of hypertension in American adults. The associations showed discrepancies by sex and ethnicity. The negative interaction between cadmium exposure and obesity influenced systolic hypertension risk.
在镉暴露与血压/高血压之间的关联以及镉与体重指数（BMI）之间的相互作用方面存在不一致之处。本研究旨在通过美国国家健康检查和营养调查（NHANES，1999-2014 年）的 8 个周期中年龄≥20 岁的 32791 名成年人的大样本（n=32791）来阐明这些不一致之处。血液（BCd）和尿液（UCd）中的镉水平被用作暴露生物标志物。建立了多元线性/逻辑回归模型，并按性别、种族和 BMI 类别进行分层。在加性和乘法尺度上评估了 BCd 和 BMI 之间的相互作用。BCd 增加两倍与黑人女性的收缩压（SBP）和舒张压（DBP）分别增加 0.54mmHg（95%CI：0.49，0.58）和 0.05mmHg（95%CI：0.04，0.06）相关。墨西哥裔美国女性的 SBP 和 DBP 分别增加 0.92mmHg（95%CI：0.73，1.11）和 0.85mmHg（95%CI：0.65，1.05）。在这些人群中，发现 BCd 与高血压之间存在显著关联（每两倍 BCd 的收缩压风险，OR=1.31；95%CI：1.07，1.61；和每两倍 BCd 的舒张压风险，OR=1.55；95%CI：1.17，2.05）。UCd 与所有个体的高血压均显著相关（每两倍 OR=1.14；95%CI：1.07，1.21）。在 BMI 类别中，镉暴露与血压/高血压之间的关联存在一些差异。在它们对收缩压高血压的影响方面，观察到 BCd 和肥胖之间存在负相互作用（RERI=-0.30；95%CI：-0.56，-0.03；OR 比值=0.55；95%CI：0.35，0.89）。我们的研究结果为镉对美国成年人血压和高血压患病率的影响提供了证据。这些关联因性别和种族而异。镉暴露与肥胖之间的负相互作用影响收缩压高血压的风险。
