Chen Yilin, Zhen Cien, Zeng Lin, Feng Hongliang, Wang Jinyu, Ai Qi Yong H, Ai Sizhi, Zhang Jihui, Liang Yannis Yan, Xue Huachen, Zhou Yujing
Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai 200040, China.
Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Department of Biology, University of Padova, Padova 35121, Italy.
Ecotoxicol Environ Saf. 2025 Jan 15;290:117541. doi: 10.1016/j.ecoenv.2024.117541. Epub 2024 Dec 14.
Physical activity (PA) may be considered an alternative method to ameliorate the elevated mortality risks associated with cadmium exposure. In this prospective cohort study, a total of 20,253 participants (weighted mean age, 47.79 years), including 10,247 men (weighted prevalence: 50.1 %), aged 18 years or older, were selected from the National Health and Nutrition Examination Survey from 2007 to 2018. Multivariable Cox proportional hazards regression models were utilized to evaluate the associations between blood cadmium levels, PA, and the risks of mortality. Restricted cubic spline analyses were employed to investigate the nonlinear relationships between blood cadmium and PA levels and mortality risks. During a median follow-up of 7.6 years, a total of 2002 (9.89 %) all-cause deaths occurred, of which 581 (2.87 %) participants were due to cardiovascular disease (CVD) and 498 (2.46 %) died of cancer. J-shaped associations were observed for blood cadmium with risks of mortality (all P < 0.001; all P < 0.001). Blood cadmium and PA had multiplicative interactions on mortality risk (all P < 0.05). Compared with the subgroup with the lowest quartile of blood cadmium and recommended PA, the combination of the highest quartile of blood cadmium and without recommended PA was associated with the highest risks of all-cause and cancer mortality, followed by those meeting recommended PA but in the highest quartile of blood cadmium (hazard ratios, 2.43; 95 % confidence interval, 1.95-3.02). Achieving recommended PA significantly attenuated the detrimental effects of blood cadmium on all-cause, CVD, and cancer mortality risks.
身体活动（PA）可被视为一种改善与镉暴露相关的死亡率升高风险的替代方法。在这项前瞻性队列研究中，从2007年至2018年的国家健康与营养检查调查中选取了总共20253名参与者（加权平均年龄47.79岁），包括10247名男性（加权患病率：50.1%），年龄在18岁及以上。使用多变量Cox比例风险回归模型来评估血镉水平、PA与死亡风险之间的关联。采用受限立方样条分析来研究血镉与PA水平以及死亡风险之间的非线性关系。在中位随访7.6年期间，总共发生了2002例（9.89%）全因死亡，其中581例（2.87%）参与者死于心血管疾病（CVD），498例（2.46%）死于癌症。观察到血镉与死亡风险呈J形关联（所有P<0.001；所有P<0.001）。血镉和PA在死亡风险上存在相乘交互作用（所有P<0.05）。与血镉处于最低四分位数且进行推荐PA的亚组相比，血镉处于最高四分位数且未进行推荐PA的组合与全因和癌症死亡的最高风险相关，其次是那些进行了推荐PA但血镉处于最高四分位数的参与者（风险比，2.43；95%置信区间，1.95 - 3.02）。达到推荐的PA显著减弱了血镉对全因、CVD和癌症死亡风险的有害影响。
