Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; IdiPaz (Hospital Universitario La Paz-Universidad Autónoma de Madrid), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; Biomedical Research Institute Hospital Clinic de Valencia (INCLIVA), Valencia, Valencia, Spain.
Environ Pollut. 2021 May 1;276:116748. doi: 10.1016/j.envpol.2021.116748. Epub 2021 Feb 16.
Cadmium (Cd) is a toxic metal found in tobacco, air and food. Recent cross-sectional studies have suggested that Cd negatively impacts physical performance, but the prospective association is uncertain.
We used data from 2548 older adults from the Seniors-ENRICA II cohort in Madrid, Spain. Whole blood Cd levels were measured at baseline using inductively coupled plasma-mass spectrometry. At baseline (2017) and follow-up (2019), overall physical function was evaluated using the physical component summary (PCS) of the SF 12-Item Health questionnaire, lower-extremity performance with the Short Physical Performance Battery (SPPB), muscle weakness with a hand dynamometer, and frailty with a Deficit Accumulation index. Mobility limitations and disability in instrumental activities of daily living (IADL) were ascertained with standardized questionnaires. Analyses were adjusted for relevant confounders, including tobacco smoke, number of cigarettes smoked per day and time since cessation in former smokers.
In cross-sectional analyses, odds ratios (95% confidence interval) per two-fold increase in blood Cd were 1.16 (1.03; 1.31) for low PCS scores, 1.08 (0.97; 1.20) for impaired lower-extremity performance, 1.10 (0.98; 1.23) for low grip strength, 1.11 (1.02; 1.20) for mobility limitations, 1.16 (1.02; 1.31) for frailty, and 1.26 (1.08; 1.47) for IADL disability. In longitudinal analyses, corresponding hazard ratios were 1.25 (1.03; 1.51) for low PCS scores, 1.14 (1.03; 1.27) for impaired lower-extremity performance, 1.02 (0.92; 1.13) for low grip strength, 1.03 (0.91; 1.16) for mobility limitations, and 1.16 (1.00; 1.35) for frailty. All the associations where consistent when current smokers were excluded from the analyses.
Our results support the role of Cd as a risk factor for physical function impairments in older adults.
镉（Cd）是一种存在于烟草、空气和食物中的有毒金属。最近的横断面研究表明，镉对身体表现有负面影响，但前瞻性关联尚不确定。
我们使用了来自西班牙马德里 Seniors-ENRICA II 队列的 2548 名老年人的数据。使用电感耦合等离子体质谱法在基线时测量全血 Cd 水平。在基线（2017 年）和随访（2019 年）时，使用 SF-12 项目健康问卷的身体成分综合评分（PCS）评估整体身体功能，使用短身体表现电池（SPPB）评估下肢表现，使用握力计评估肌肉无力，使用缺陷积累指数评估虚弱。通过标准化问卷确定移动受限和日常生活活动（IADL）中的残疾情况。分析调整了相关混杂因素，包括烟草烟雾、每天吸烟的香烟数量和以前吸烟者的戒烟时间。
在横断面分析中，血液 Cd 水平每增加两倍的比值比（95%置信区间）分别为：PCS 评分低（1.16[1.03；1.31]）、下肢功能受损（1.08[0.97；1.20]）、握力低（1.10[0.98；1.23]）、移动受限（1.11[1.02；1.20]）、虚弱（1.16[1.02；1.31]）和 IADL 残疾（1.26[1.08；1.47]）。在纵向分析中，相应的风险比分别为：PCS 评分低（1.25[1.03；1.51]）、下肢功能受损（1.14[1.03；1.27]）、握力低（1.02[0.92；1.13]）、移动受限（1.03[0.91；1.16]）和虚弱（1.16[1.00；1.35]）。当排除分析中的当前吸烟者时，所有关联均保持一致。
我们的研究结果支持 Cd 作为老年人身体功能障碍的危险因素的作用。
