Liu Jialin, Li Yiling, Li Dong, Wang Yibaina, Wei Sheng
MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
Center for Statistical Science, Department of Industrial Engineering, Tsinghua University, Beijing 100084, PR China.
Sci Total Environ. 2022 Jun 15;825:153997. doi: 10.1016/j.scitotenv.2022.153997. Epub 2022 Feb 22.
Cadmium (Cd) is a metal with a long biological half-life that could cause health issues, such as coronary heart disease (CHD), stroke, and other cardiovascular diseases (CVD). Recent studies showed an ascending trend in the dietary Cd intake in the Chinese population. The contribution of dietary Cd intake to CHD and stroke burden, on the other hand, remains to be established. To calculate the disease burden for CHD and stroke attributable to dietary Cd, we estimated dietary Cd intake by associating the Cd concentration in food with consumption frequency. The toxicokinetic (TK) model and dietary Cd consumption were used to simulate urinary cadmium (U-Cd) concentrations. The population attributable fraction (PAF) can be derived for the computation of the attributable disease burden expressed as Disability-Adjusted Life Years (DALYs) in provinces, genders, and age groups by combining the relative risk (RR) with the population distribution of U-Cd. The mean of dietary Cd consumption and the geometric mean of U-Cd in the Chinese adult population are 0.684 μg/kg bw/day and 0.88 μg/g creatinine. The CHD burden attributable to dietary Cd was 3.26 million DALYs, with a 9.69% proportion of the total CHD burden. The DALYs for stroke attributable to Cd in food was approximately 3.64 million, accounting for 8.22% of the overall stroke burden. Furthermore, the attributable disease burden of CHD and stroke are higher in the south, women, and middle-aged and older adults. Our study suggested that foodborne Cd exposure contributes a considerable proportion of the CHD and stroke burden. More attention is needed to control Cd in food in order to reduce the burden of CHD and stroke in the Chinese population.
镉（Cd）是一种生物半衰期较长的金属，可引发健康问题，如冠心病（CHD）、中风及其他心血管疾病（CVD）。近期研究表明，中国人群膳食镉摄入量呈上升趋势。另一方面，膳食镉摄入对冠心病和中风负担的影响仍有待确定。为计算膳食镉导致的冠心病和中风疾病负担，我们通过将食物中的镉浓度与消费频率相关联来估算膳食镉摄入量。利用毒物动力学（TK）模型和膳食镉消费量来模拟尿镉（U-Cd）浓度。通过将相对风险（RR）与U-Cd的人群分布相结合，可得出人群归因分数（PAF），用于计算按省份、性别和年龄组表示为伤残调整生命年（DALYs）的归因疾病负担。中国成年人群膳食镉消费量的均值和U-Cd的几何均值分别为0.684μg/kg体重/天和0.88μg/g肌酐。膳食镉导致的冠心病负担为326万DALYs，占冠心病总负担的9.69%。食物中镉导致的中风DALYs约为364万，占中风总负担的8.22%。此外，表示为伤残调整生命年（DALYs）的归因疾病负担在南方、女性以及中老年人群中更高。我们的研究表明，食物源性镉暴露在冠心病和中风负担中占相当大的比例。为减轻中国人群的冠心病和中风负担，需要更加关注控制食物中的镉。
