Caffeine Intake Attenuates the Association of Cadmium Exposure with Cardiovascular Disease: National Health and Nutrition Examination Survey (NHANES) 2003-2016.

BACKGROUND

Cadmium exposure has been linked to an increased risk of cardiovascular disease (CVD). Moderate caffeine intake may reduce the risk of CVD. Whether caffeine intake attenuates the association of cadmium exposure with CVD remains unknown.

METHODS

The study used cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2016. Cadmium exposure was estimated by urinary cadmium after adjusting for urinary creatinine (UCd/Cr, μg/g). Caffeine intake was determined using the average of two 24-h dietary recalls. Logistic regression models were used to examine the association of cadmium exposure with CVD and to evaluate the multiplicative interaction between caffeine intake and cadmium exposure.

RESULTS

A total of 7,094 adults aged 20 or older were included in the study, of whom 827 had CVD. The multivariate-adjusted odds ratio (OR) of participants in the highest quartile was 2.10 (95% confidence interval: 1.34-3.28) for CVD compared to participants in the lowest UCd/Cr quartile. The OR of ln-UCd/Cr as a continuous variable was 1.46 (95% confidence interval: 1.23-1.73). Moreover, a significant interaction between caffeine intake and cadmium exposure on CVD was observed (P for interaction = 0.004). The relatively lowest ORs of cadmium exposure with CVD were observed in participants with low or moderate caffeine intake (caffeine intake quartile 2 and quartile 3) in almost all subgroups.

CONCLUSIONS

Higher cadmium exposure was associated with increased CVD risk in US adults. Low-to-moderate caffeine intake tends to attenuate this association. Further studies are needed to confirm causality and underlying mechanisms.