1
|
Verzelloni P, Urbano T, Wise LA, Vinceti M, Filippini T. Cadmium exposure and cardiovascular disease risk: A systematic review and dose-response meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 345:123462. [PMID: 38295933 DOI: 10.1016/j.envpol.2024.123462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/30/2023] [Accepted: 01/27/2024] [Indexed: 02/05/2024]
Abstract
Exposure to toxic metals is a global public health threat. Among other adverse effects, exposure to the heavy metal cadmium has been associated with greater risk of cardiovascular disease (CVD). Nonetheless, the shape of the association between cadmium exposure and CVD risk is not clear. This systematic review summarizes data on the association between cadmium exposure and risk of CVD using a dose-response approach. We carried out a literature search in PubMed, Web of Science, and Embase from inception to December 30, 2023. Inclusion criteria were: studies on adult populations, assessment of cadmium exposure, risk of overall CVD and main CVD subgroups as endpoints, and observational study design (cohort, cross-sectional, or case-control). We retrieved 26 eligible studies published during 2005-2023, measuring cadmium exposure mainly in urine and whole blood. In a dose-response meta-analysis using the one-stage method within a random-effects model, we observed a positive association between cadmium exposure and risk of overall CVD. When using whole blood cadmium as a biomarker, the association with overall CVD risk was linear, yielding a risk ratio (RR) of 2.58 (95 % confidence interval-CI 1.78-3.74) at 1 μg/L. When using urinary cadmium as a biomarker, the association was linear until 0.5 μg/g creatinine (RR = 2.79, 95 % CI 1.26-6.16), after which risk plateaued. We found similar patterns of association of cadmium exposure with overall CVD mortality and risks of heart failure, coronary heart disease, and overall stroke, whereas for ischemic stroke there was a positive association with mortality only. Overall, our results suggest that cadmium exposure, whether measured in urine or whole blood, is associated with increased CVD risk, further highlighting the importance of reducing environmental pollution from this heavy metal.
Collapse
Affiliation(s)
- Pietro Verzelloni
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Teresa Urbano
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA.
| |
Collapse
|
2
|
Sakuma S, Nogawa K, Watanabe Y, Sakurai M, Nishijo M, Ishizaki M, Morikawa Y, Kido T, Nakagawa H, Suwazono Y. Effect of renal tubular damage on non-cancer mortality in the general Japanese population living in cadmium non-polluted areas. J Appl Toxicol 2023; 43:1849-1858. [PMID: 37460094 DOI: 10.1002/jat.4518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/12/2023] [Accepted: 06/27/2023] [Indexed: 11/10/2023]
Abstract
This study aimed to clarify the cause-effect relationship between renal tubular damage and non-cancer mortality in the general Japanese population. We conducted a 19-year cohort study including 1110 men and 1,03 women who lived in three cadmium-non-polluted areas in 1993 or 1994. Mortality risk ratios based on urinary β2-microglobulin (β2MG) and N-acetyl-β-glucosaminidase (NAG) concentrations were estimated for specific non-cancer diseases using the Fine and Gray competing risks regression model. In men, continuous urinary NAG (+1 μg/g cre) concentrations were significantly correlated with increased mortality caused by diseases of the respiratory system (hazard ratio (HR): 1.09, 95% confidence interval (CI): 1.03-1.15). Urinary β2MG (+100 μg/g cre) concentrations were significantly correlated with increased mortalities caused by kidney and urinary tract diseases (HR: 1.01, 95% CI: 1.00-1.03), renal diseases (HR: 1.01, 95% CI: 1.00-1.03), renal failure (HR: 1.02, 95% CI: 1.00-1.03), and external causes of mortality (HR: 1.01, 95% CI: 1.00-1.02). In women, urinary NAG (+1 μg/g cre) concentrations were significantly associated with increased mortality caused by ischemic heart diseases (HR: 1.02, 95% CI: 1.00-1.04) and kidney and urinary tract diseases (HR: 1.01, 95% CI: 1.00-1.04). Urinary β2MG (+100 μg/g cre) concentrations were significantly correlated with increased mortality caused by cardiovascular diseases (HR: 1.01, 95%CI: 1.00-1.02), ischemic heart diseases (HR: 1.01, 95%CI: 1.00-1.02), and kidney and urinary tract diseases (HR: 1.02, 95% CI: 1.01-1.03). The present study indicates that renal tubular damage was significantly related to several non-cancer disease causes of mortality in Japan's general population living in cadmium-non-polluted areas.
Collapse
Affiliation(s)
- Sayaka Sakuma
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuuka Watanabe
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masaru Sakurai
- Department of Hygiene, Kanazawa Medical University, Ishikawa, Japan
| | - Muneko Nishijo
- Department of Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Masao Ishizaki
- Department of Hygiene, Kanazawa Medical University, Ishikawa, Japan
| | - Yuko Morikawa
- Department of Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Teruhiko Kido
- Department of Community Health Nursing, Kanazawa University School of Health Sciences, Ishikawa, Japan
| | - Hideaki Nakagawa
- Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| |
Collapse
|
3
|
Moon S, Lee J, Yu JM, Choi H, Choi S, Park J, Choi K, Kim E, Kim H, Kim MJ, Park YJ. Association between environmental cadmium exposure and increased mortality in the U.S. National Health and Nutrition Examination Survey (1999-2018). JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:874-882. [PMID: 37161056 DOI: 10.1038/s41370-023-00556-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Cadmium (Cd) is toxic to human health and increases overall mortality. In this study, we investigated the association between Cd exposure and all-cause, cardiovascular (CVD), and cancer mortality in the general population and the mediating effect of smoking on these association. METHODS We used data from U.S. National Health and Nutrition Examination Survey for 1999-2018. To evaluate the hazard ratio (HR) for mortality, a multiple Cox regression analysis was conducted by adjusting for age, sex, race/ethnicity, body mass index, smoking, alcohol, hypertension, diabetes, hyperlipidemia, and history of CVD and cancer. A causal mediation analysis was performed to estimate the effects of smoking. RESULTS Among the 31,637 subjects, 5452 (12.3%) died. Blood Cd concentrations were significantly associated with all-cause (HR 1.473, 95% confidence interval [CI] 1.403-1.546, p < 0.001), CVD (HR 1.445, 95% CI 1.344-1.554, p < 0.001), and cancer (HR 1.496, 95% CI 1.406-1.592, p < 0.001) mortality. Urinary Cd concentrations were also significantly associated with them. Using feature selection via machine learning, the importance of Cd in all-cause and cancer mortality was second only to age. The association between Cd concentrations and all-cause mortality was significant in both ever-smokers and never-smokers. The mediating effect of smoking was estimated at 32%, whereas a large proportion (68%) remained a direct effect of Cd. In a subgroup analysis of subjects with cancer history, blood Cd concentrations were significantly associated with cancer-related deaths in those with a history of breast, gastrointestinal, and skin cancers. CONCLUSION High Cd exposure is an important risk factor for all-cause, CVD, and cancer mortality among the general population. Cd exposure increased the risk of death even in never-smokers, and its effects unrelated to smoking were substantial, suggesting the importance of regulating other sources of Cd exposure such as food and water. IMPACT STATEMENT Using national large-scale data, we found that low-level environmental exposure to cadmium significantly increased the risk of all-cause, cardiovascular, and cancer mortality in the general population even after adjusting for several risk factors. Although smoking is a major source of cadmium exposure, cadmium was nevertheless significantly associated with all-cause mortality in never-smokers, and the mediating effect of smoking on this association was only 32%. Hence, other sources of cadmium exposure such as food and water may be important.
Collapse
Affiliation(s)
- Shinje Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Junghoon Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Jae Myung Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Hoonsung Choi
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Sohyeon Choi
- Department of Environmental Health Sciences, Soonchunhyang University, Asan, Republic of Korea
| | - Jeongim Park
- Department of Environmental Health Sciences, Soonchunhyang University, Asan, Republic of Korea
| | - Kyungho Choi
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Ejin Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Min Joo Kim
- Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
4
|
Shi JW, Fan DX, Li MQ. The Relationship between Cadmium Exposure and Mortality in Postmenopausal Females: A Cohort Study of 2001-2018 NHANES. Nutrients 2023; 15:4604. [PMID: 37960256 PMCID: PMC10647223 DOI: 10.3390/nu15214604] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/22/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Cadmium is one of the most harmful elements to human health, and the health of postmenopausal females is an important public health issue. However, the correlation between exposure to cadmium and the survival status of postmenopausal women is currently not fully clear. This research intended to explore the correlation between cadmium exposure and mortality among postmenopausal females using a representative sample of the population in the U.S. We drew upon the data of the National Health and Nutrition Examination Survey (2001-2018). Cox's proportional hazards models and a restricted cubic spline regression (RCS) model were utilized to analyze the correlation between blood and urine cadmium and the mortality of postmenopausal women. Stratified analyses also were conducted to identify the highest risk factor of mortality for the participants. The mean concentration of blood cadmium was 0.59 μg/L, and the mean concentration of urine cadmium was 0.73 μg/g creatinine. Higher cadmium concentrations in blood and urine were significantly related to an increase in all-cause mortality for postmenopausal females after adjustment for multivariate covariates. Furthermore, there was a linear positive correlation between urine cadmium concentrations and cancer mortality, while there was no correlation between blood cadmium and cancer death. The correlation between cadmium concentrations and all-cause mortality is stronger in older, more overweight women with a history of hypertension or smoking. We propose that cadmium remains an important risk factor of all-cause and cancer mortality among postmenopausal females in the U.S. Further decreases in cadmium exposure in the population can promote the health of postmenopausal women and prolong their lifespan.
Collapse
Affiliation(s)
- Jia-Wei Shi
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, China;
- Institute of Obstetrics and Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, China
| | - Deng-Xuan Fan
- Department of Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, China
| | - Ming-Qing Li
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, China;
- Institute of Obstetrics and Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, China
| |
Collapse
|
5
|
Pokharel A, Wu F. Dietary exposure to cadmium from six common foods in the United States. Food Chem Toxicol 2023:113873. [PMID: 37271274 DOI: 10.1016/j.fct.2023.113873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
Recently, the United States (US) Food and Drug Administration (FDA) launched a Closer to Zero Action Plan to assess the risks of and develop action levels for certain heavy metals in food including cadmium (Cd). The problem of foodborne metal contamination has taken on new urgency, thanks in part to a 2021 US Congressional Report detailing high levels of metals found in infant food. Our risk assessment aids this FDA Action Plan by estimating the American population's Cd exposures in food, by age group and consumption patterns of certain high-risk foods; and by determining circumstances in which exposures exceed tolerable daily intakes developed by policymaking groups in the US and worldwide. We found that the age groups 6-24 months and 24-60 month old are the most highly exposed to Cd in common foodstuffs. American infants and young children of these age groups who regularly consumed rice, spinach, oats, barley, potatoes, and wheat had mean Cd exposures exceeding maximum tolerable intake level was set by the Agency for Toxic Substances and Disease Registry (ATSDR). We have identified age groups at highest potential risk, and therefore of interest for developing food safety policies to improve safety of commercial food for children.
Collapse
Affiliation(s)
- Ashish Pokharel
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, USA
| | - Felicia Wu
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, USA; Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA.
| |
Collapse
|
6
|
Laouali N, Benmarhnia T, Lanphear BP, Oulhote Y. Associations with Blood Lead and Urinary Cadmium Concentrations in Relation to Mortality in the US Population: A Causal Survival Analysis with G-Computation. TOXICS 2023; 11:toxics11020133. [PMID: 36851008 PMCID: PMC9966985 DOI: 10.3390/toxics11020133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 05/19/2023]
Abstract
Using the parametric g-formula, we estimated the 27-year risk of all-cause and specific causes of mortality under different potential interventions for blood lead (BLLs) and urinary cadmium (UCd) levels. We used data on 14,311 adults aged ≥20 years enrolled in the NHANES-III between 1988 and 1994 and followed up through 31 Dec 31 2015. Time and cause of death were determined from the National Death Index records. We used the parametric g-formula with pooled logistic regression models to estimate the relative and absolute risk of all-cause, cardiovascular, and cancer mortality under different potential threshold interventions for BLLs and UCd concentrations. Median follow-up was 22.5 years. A total of 5167 (36%) participants died by the end of the study, including 1550 from cardiovascular diseases and 1135 from cancer. Increases in BLLs and creatinine-corrected UCd levels from the 5th to the 95th percentiles were associated with risk differences of 4.17% (1.54 to 8.77) and 6.22% (4.51 to 12.00) for all-cause mortality, 1.52% (0.09 to 3.74) and 1.06% (-0.57 to 3.50) for cardiovascular disease mortality, and 1.32% (-0.09 to 3.67) and 0.64% (-0.98 to 2.80) for cancer mortality, respectively. Interventions to reduce historical exposures to lead and cadmium may have prevented premature deaths, especially from cardiovascular disease.
Collapse
Affiliation(s)
- Nasser Laouali
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, MA 01003, USA
- Scripps Institution of Oceanography, University of California, San Diego, CA 95616, USA
- CESP UMR1018, Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, 94800 Villejuif, France
- Correspondence:
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, CA 95616, USA
| | - Bruce P. Lanphear
- Child and Family Research Institute, BC Children’s Hospital, Vancouver, BC V6H 3N1, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Youssef Oulhote
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, MA 01003, USA
| |
Collapse
|
7
|
Sakurai M, Suwazono Y, Nogawa K, Watanabe Y, Takami M, Ogra Y, Tanaka YK, Iwase H, Tanaka K, Ishizaki M, Kido T, Nakagawa H. Cadmium body burden and health effects after restoration of cadmium-polluted soils in cadmium-polluted areas in the Jinzu River basin. Environ Health Prev Med 2023; 28:49. [PMID: 37690834 PMCID: PMC10495241 DOI: 10.1265/ehpm.23-00132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/21/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Itai-itai disease is caused by environmental cadmium (Cd) pollution in the Jinzu River basin in Japan. To reduce the Cd contamination of rice, soil restoration of paddy fields was carried out. We evaluated the effect of soil restoration on the health status of residents of the former Cd-polluted area. METHODS Participants were 1,030 men and 944 women who lived in the area of restoration of Cd-polluted rice paddies. First morning urine was collected and urinary Cd, β2-microglobulin (β2MG), and N-acetyl-β-D-glucosaminidase (NAG) levels were measured. Associations among age, years of residence before and after soil restoration, and urinary Cd, β2MG, and NAG levels were evaluated by multiple regression analysis. RESULTS The geometric mean (interquartile range) of urinary Cd (µg/g Cr) was 1.00 (0.58-1.68) in men and 1.67 (1.02-2.91) in women. The geometric means of urinary β2MG (µg/g Cr) and NAG (U/g Cr) were 174.6 (92.6-234.2) and 1.47 (0.72-3.14) in men, and 217.6 (115.3-28.7) and 1.48 (0.73-2.96) in women, respectively. Urinary Cd, β2MG, and NAG were significantly positively correlated (p < 0.01 all). Age and duration of residence in the Cd-polluted area before soil restoration were independently associated with urinary Cd, β2MG, and NAG. Among the 916 participants who had resided in the area before the soil restoration, urinary Cd concentrations were significantly higher, thus by 1.03-fold (95% CI, 1.01-1.04) in men and 1.03-fold (95% CI, 1.01-1.05) in women, when the years of residence before soil restoration by each 5-years increment. By contrast, urinary Cd concentrations were significantly lower, thus 0.97-fold (95% CI, 0.96-0.99) lower in men and 0.97-fold (95% CI, 0.95-0.99) lower in women, by each 5-year increment of residence after soil restoration. A similar association was observed for urinary β2MG concentration, and no significant association was observed for urinary NAG levels in men or women. CONCLUSIONS Cd exposure and associated renal tubular dysfunction in residents of a former Cd-polluted area were influenced by Cd exposure from the environment prior to soil restoration. Soil restoration in Cd-polluted areas reduced the Cd exposure of local residents.
Collapse
Affiliation(s)
- Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada 920-0293, Japan
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
| | - Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
| | - Yuuka Watanabe
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
| | - Miyuki Takami
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
| | - Yasumitsu Ogra
- Graduate School of Pharmaceutical Sciences, Chiba University, Chiba 260-8675, Japan
| | - Yu-Ki Tanaka
- Graduate School of Pharmaceutical Sciences, Chiba University, Chiba 260-8675, Japan
| | - Hirotaro Iwase
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
| | - Kayo Tanaka
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
| | - Masao Ishizaki
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada 920-0293, Japan
| | - Teruhiko Kido
- School of Health Sciences, Kanazawa University, Kanazawa 920-0942, Japan
| | - Hideaki Nakagawa
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada 920-0293, Japan
| |
Collapse
|
8
|
Tavakoli Pirzaman A, Ebrahimi P, Niknezhad S, Vahidi T, Hosseinzadeh D, Akrami S, Ashrafi AM, Moeen Velayatimehr M, Hosseinzadeh R, Kazemi S. Toxic mechanisms of cadmium and exposure as a risk factor for oral and gastrointestinal carcinomas. Hum Exp Toxicol 2023; 42:9603271231210262. [PMID: 37870872 DOI: 10.1177/09603271231210262] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
Incidence and mortality rates of gastrointestinal (GI) and oral cancers are among the highest in the world, compared to other cancers. GI cancers include esophageal, gastric, colon, rectal, liver, and pancreatic cancers, with colorectal cancer being the most common. Oral cancer, which is included in the head and neck cancers category, is one of the most important causes of death in India. Cadmium (Cd) is a toxic element affecting humans and the environment, which has both natural and anthropogenic sources. Generally, water, soil, air, and food supplies are reported as some sources of Cd. It accumulates in organs, particularly in the kidneys and liver. Exposure to cadmium is associated with different types of health risks such as kidney dysfunction, cardiovascular disease, reproductive dysfunction, diabetes, cerebral infarction, and neurotoxic effects (Parkinson's disease (PD) and Alzheimer's disease (AD)). Exposure to Cd is also associated with various cancers, including lung, kidney, liver, stomach, hematopoietic system, gynecologic and breast cancer. In the present study, we have provided and summarized the association of Cd exposure with oral and GI cancers.
Collapse
Affiliation(s)
| | - Pouyan Ebrahimi
- Student Research Committee, Babol University of Medical Science, Babol, Iran
| | - Shokat Niknezhad
- Student Research Committee, Babol University of Medical Science, Babol, Iran
| | - Turan Vahidi
- Student Research Committee, Babol University of Medical Science, Babol, Iran
| | | | - Sousan Akrami
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arash M Ashrafi
- Student Research Committee, Babol University of Medical Science, Babol, Iran
| | | | - Rezvan Hosseinzadeh
- Student Research Committee, Babol University of Medical Science, Babol, Iran
| | - Sohrab Kazemi
- Cellular and Molecular Biology Research Center, Health Research Center, Babol University of Medical Science, Babol, Iran
| |
Collapse
|
9
|
Laouali N, Benmarhnia T, Oulhote Y. Potential benefits of joint hypothetical interventions on diet, lead, and cadmium on mortality in US adults. Environ Health 2022; 21:93. [PMID: 36195905 PMCID: PMC9533558 DOI: 10.1186/s12940-022-00905-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/19/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Previous studies reported associations between high blood lead levels (BLLs) and urinary cadmium (UCd) concentrations and all-cause and cause-specific mortality. It is hypothesized that these associations are mediated by inflammation; therefore, adherence to an anti-inflammatory diet may mitigate these effects. We sought to estimate the potential effects of joint hypothetical interventions on metals levels and adherence to an anti-inflammatory diet or fruits and vegetables (FV) intake on the expected mortality distributions. METHODS We used data on 14,311 adults aged ≥ 20 years enrolled in the NHANES-III between 1988 and 1994 and followed up through Dec 31, 2015. We estimated daily FV servings and adherence to the dietary inflammatory index at baseline using 24-hour dietary recalls. Mortality was determined from the National Death Index records. We used the parametric g-formula with pooled logistic regression models to estimate the absolute risk of all-cause, cardiovascular, and cancer mortality under different hypothetical interventions compared to the natural course (no intervention). RESULTS Overall, we observed a decreased mortality risk when intervening to lower metals levels or increasing adherence to an anti-inflammatory diet or the daily FV servings. The joint intervention to lower BLLs and UCd and increase the adherence to the anti-inflammatory diet had the strongest impact on cancer mortality risk (risk difference [RD] = -1.50% (-2.52% to -0.62%)) compared to the joint intervention only on metals levels RD= -0.97% (-1.89 to 0.70). The same pattern of associations was observed for the joint intervention to lower both metals and increased daily FV servings and cardiovascular diseases mortality risk. CONCLUSION Higher diet quality may constitute a complementary approach to the interventions to reduce exposures to cadmium and lead to further minimize their effects on mortality. A paradigm shift is required from a pollutant-focused only to a combination with a human-focused approach for primary prevention against these metals.
Collapse
Affiliation(s)
- Nasser Laouali
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, MA, USA.
- Scripps Institution of Oceanography, University of California, San Diego, USA.
- Centre for Research in Epidemiology and Population Health (CESP): Exposome and Heredity team, Inserm (Institut National de la Santé et de la Recherche Médicale) U1018, Gustave Roussy Institute, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France.
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, USA
| | - Youssef Oulhote
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, MA, USA
| |
Collapse
|
10
|
Guo X, Su W, Li N, Song Q, Wang H, Liang Q, Li Y, Lowe S, Bentley R, Zhou Z, Song EJ, Cheng C, Zhou Q, Sun C. Association of urinary or blood heavy metals and mortality from all causes, cardiovascular disease, and cancer in the general population: a systematic review and meta-analysis of cohort studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:67483-67503. [PMID: 35917074 DOI: 10.1007/s11356-022-22353-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
Amounting epidemiological evidence has shown detrimental effects of heavy metals on a wide range of diseases. However, the effect of heavy metal exposure on mortality in the general population remains unclear. The primary objective of this study was to clarify the associations between heavy metals and mortality from all causes, cardiovascular disease (CVD), and cancer based on prospective studies. We comprehensively searched Pubmed, Embase, and Web of Science electronic databases to identify studies published from their inception until 1 March 2022. Investigators identified inclusion criteria, extracted study characteristics, and assessed the methodological quality of included studies according to standardized guidelines. Meta-analysis was conducted if the effect estimates of the same outcome were reported in at least three studies. Finally, 42 original studies were identified. The results of meta-analysis showed that cadmium and lead exposure was significantly associated with mortality from all causes, CVD, and cancer in the general population. Moderate evidence suggested there was a link between arsenic exposure and mortality. The adverse effects of mercury and other heavy metals on mortality were inconclusive. Epidemiological evidence for the joint effect of heavy metal exposure on mortality was still indeterminate. In summary, our study provided compelling evidence that exposure to cadmium, lead, and arsenic were associated with mortality from all causes, CVD, and cancer, while the evidence on other heavy metals, for example mercury, was insignificant or indeterminate. Nevertheless, further prospective studies are warranted to explore the joint effects of multiple metal exposure on mortality.
Collapse
Affiliation(s)
- Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - Yaru Li
- Internal Medicine, Swedish Hospital, 5140 N California Ave, Chicago, IL, 60625, USA
- College of Osteopathic Medicine, Des Moines University, 3200 Grand Ave, Des Moines, IA, 50312, USA
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Rachel Bentley
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Zhen Zhou
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, TAS, 7000, Australia
| | - Evelyn J Song
- Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Ce Cheng
- The University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, 85724, USA
- Banner-University Medical Center South, 2800 E Ajo Way, Tucson, AZ, 85713, USA
| | - Qin Zhou
- Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, IL, 60657, USA.
| |
Collapse
|
11
|
Yen CC, Chen HH, Hsu YT, Tseng CJ, Lin CH. Effects of heavy metals in acute ischemic stroke patients: A cross-sectional study. Medicine (Baltimore) 2022; 101:e28973. [PMID: 35244065 PMCID: PMC8896421 DOI: 10.1097/md.0000000000028973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022] Open
Abstract
Cerebrovascular disease is the second commonest cause of mortality globally and among the commonest causes of disability. However, research executed to probe the heavy metal exposure-stroke incidence relationship is scarce. Accordingly, we executed our study to probe the relationship of heavy metal concentrations (ie, concentrations of lead [Pb], mercury [Hg], cadmium [Cd], and arsenic) in the serum and urine of acute ischemic stroke (AIS) patients with several patient variables.For enrollment, we chose patients who had a first AIS within 7 days after the onset of a stroke. Thus, 33 newly diagnosed patients with AIS were recruited. We determined the aforementioned metals' concentrations by executing inductively coupled plasma mass spectrometry. We also gauged the association between such metal concentrations and patient variables by employing Spearman correlation coefficient. To examine the differences in metal concentrations between the different variables, we implemented an independent Mann-Whitney U test.In our cohort analysis, we noted serum Pb and Cd concentrations to be positively correlated with serum creatinine and hemoglobin. Serum and urine Cd concentrations had a negative correlation with impaired HbA1c in AIS patients. Urine Hg had a positive correlation with C-reactive protein in the participants. Participants who smoked or consumed alcohol had significantly higher Pb and Cd levels in serum than did those who neither smoked nor drank. Patients with AIS who smoked or consumed alcohol had high levels of serum Pb and serum Cd than did those who did not. Patients with AIS who consumed alcohol had significantly higher Pb and Hg urine concentrations than did those who did not.Our study indicated that serum Cd and Pb elevation increased the AIS risk in southern Taiwan patients.
Collapse
Affiliation(s)
- Cheng-Chang Yen
- Section of Neurology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Rd., Kaohsiung, Taiwan
- Department of Electrical Engineering, Southern Taiwan University of Science and Technology, No. 1, Nan-Tai Street, Yongkang Dist., Tainan, Taiwan
| | - Hsin-Hung Chen
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Rd., Kaohsiung, Taiwan
| | - Yi-Ting Hsu
- Section of Neurology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Rd., Kaohsiung, Taiwan
| | - Ching-Jiunn Tseng
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Rd., Kaohsiung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, No. 2, Yude Rd., Taichung, Taiwan
| | - Ching-Huang Lin
- Section of Neurology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Rd., Kaohsiung, Taiwan
- Department of Biological Sciences, National Sun Yat-Sen University, 70 Lienhai Rd., Kaohsiung, Taiwan
- Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, No. 452, Huanqiu Rd. Luzhu Dist., Kaohsiung, Taiwan
| |
Collapse
|
12
|
Nogawa K, Watanabe Y, Sakuma S, Sakurai M, Nishijo M, Ishizaki M, Morikawa Y, Kido T, Nakagawa H, Suwazono Y. Renal tubular dysfunction and cancer mortality in the Japanese general population living in cadmium non-contaminated areas. J Appl Toxicol 2022; 42:1458-1466. [PMID: 35181909 DOI: 10.1002/jat.4304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/01/2022] [Accepted: 02/12/2022] [Indexed: 11/08/2022]
Abstract
The relationship between cadmium exposure, exposure-related renal tubular dysfunction, and mortality have been reported, mainly in the residents of Cd contaminated areas in Japan. The aim of this study was to establish the cause-effect relationship between renal tubular dysfunction and cancer mortality in the general population in non-contaminated areas. A 19-year cohort study was conducted in 1110 men and 1703 women in 1993 or 1994, who lived in three cadmium non-contaminated areas. Mortality risk ratios of urinary β2-microglobulin (β2MG) and N-acetyl-β-glucosaminidase (NAG) for all malignant neoplasms and specific cancers were estimated using the Fine and Gray competing risks regression model. Significant HRs for liver and pancreas cancer were observed for NAG (liver: HR corresponding to an increase of 1IU/g cr, 1.10, 95%CI, 1.02-1.19, pancreas: HR, 1.10, 95%CI, 1.02-1.19) in men. In women, a negative HR was observed for NAG (lung cancer: HR 0.80, 95% CI, 0.67-0.96) and for β2MG (all malignant neoplasms: HR, 0.97, 95% CI, 0.93-1.00). The present study indicated that renal tubular dysfunction was significantly related to mortality in the general population of cadmium non-contaminated areas in Japan.
Collapse
Affiliation(s)
- Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuuka Watanabe
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Sayaka Sakuma
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masaru Sakurai
- Department of Hygiene, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Muneko Nishijo
- Department of Public Health, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Masao Ishizaki
- Department of Hygiene, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Yuko Morikawa
- Department of Public Health, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Teruhiko Kido
- Department of Community Health Nursing, Kanazawa University School of Health Sciences, Kanazawa, Ishikawa, Japan
| | - Hideaki Nakagawa
- Medical Research Institute, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| |
Collapse
|
13
|
Sakurai M, Suwazono Y, Nishijo M, Nogawa K, Watanabe Y, Yoneda K, Ishizaki M, Morikawa Y, Kido T, Nakagawa H. The Relationship between the Urinary Cadmium Concentration and Cause-Specific Mortality in Subjects without Severe Renal Damage: A 35-Year Follow-Up Study in a Cadmium-Polluted Area of Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157747. [PMID: 34360038 PMCID: PMC8345790 DOI: 10.3390/ijerph18157747] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/17/2021] [Accepted: 07/20/2021] [Indexed: 11/26/2022]
Abstract
We evaluated the association between urinary cadmium concentration (uCd, μg/g Cr) and risk of cause-specific mortality according to urinary β2-microglobulin (MG) concentration. Participants were 1383 male and 1700 female inhabitants of the Cd-polluted Kakehashi River basin. The uCd and β2-MG were evaluated in a survey in 1981–1982, where those participants were followed-up over 35 years later. Among the participants with a urinary β2-MG < 1000, the hazard ratios (HRs) (95% confidence interval) for mortality were significantly higher in those with a uCd of ≥10.0 compared with <5.0 for cardiovascular disease [HR 1.92 (1.08–3.40) for men, 1.71 (1.07–2.71) for women], pneumonia or influenza [2.10 (1.10–4.00) for men, 2.22 (1.17–4.19) for women], and digestive diseases [for men; 3.81 (1.49–9.74)]. The uCd was significantly associated with mortality from heart failure in women and digestive diseases in men, after adjustment for other causes of death using the Fine and Gray competing risk regression model. For participants with a urinary β2-MG of ≥1000, no significant association was observed between uCd and any major cause of death. In the absence of kidney damage, Cd may increase the risk of death from cardiovascular disease, pneumonia, and digestive diseases.
Collapse
Affiliation(s)
- Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, Ishikawa 920-0293, Japan; (K.Y.); (M.I.); (H.N.)
- Health Evaluation Center, Kanazawa Medical University, Ishikawa 920-0293, Japan
- Correspondence:
| | - Yasushi Suwazono
- Department of Occupation and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (Y.S.); (K.N.); (Y.W.)
| | - Muneko Nishijo
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa 920-0293, Japan;
| | - Kazuhiro Nogawa
- Department of Occupation and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (Y.S.); (K.N.); (Y.W.)
| | - Yuuka Watanabe
- Department of Occupation and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (Y.S.); (K.N.); (Y.W.)
| | - Kazuka Yoneda
- Department of Social and Environmental Medicine, Kanazawa Medical University, Ishikawa 920-0293, Japan; (K.Y.); (M.I.); (H.N.)
| | - Masao Ishizaki
- Department of Social and Environmental Medicine, Kanazawa Medical University, Ishikawa 920-0293, Japan; (K.Y.); (M.I.); (H.N.)
- Health Evaluation Center, Kanazawa Medical University, Ishikawa 920-0293, Japan
| | - Yuko Morikawa
- School of Nursing, Kanazawa Medical University, Ishikawa 920-0293, Japan;
| | - Teruhiko Kido
- School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa 920-0942, Japan;
| | - Hideaki Nakagawa
- Department of Social and Environmental Medicine, Kanazawa Medical University, Ishikawa 920-0293, Japan; (K.Y.); (M.I.); (H.N.)
| |
Collapse
|
14
|
Nguyen HD, Kim MS. Effects of heavy metal, vitamin, and curry consumption on metabolic syndrome during menopause: a Korean community-based cross-sectional study. Menopause 2021; 28:949-959. [PMID: 34284432 DOI: 10.1097/gme.0000000000001825] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine the associations between metabolic syndrome (MetS) during menopause and serum heavy metal levels and vitamin and curry consumption. METHODS A data set of 7,131 pre- and postmenopausal women aged ≥ 20 years collected between 2009 and 2017 was used to obtain information on sociodemographic, lifestyles, family histories, food intakes, and serum heavy metal levels and MetS. Logistic regression was used to identify associations between the presence of MetS and risk factors and to predict risks of MetS based on marginal effects. RESULTS Our results show that postmenopausal women had a higher risk of MetS than premenopausal women. During postmenopause elevations in the levels of serum cadmium by one unit increased the risk of MetS by 33% (OR 1.33; 95% CI, 1.03-1.72, P = 0.028). Risks of MetS in pre- and postmenopausal women, when serum Hb levels increased by 1 unit increased 21% (OR 1.21; 95% CI, 1.09-1.33, P < 0.001) and 26% (OR 1.26; 95% CI, 1.16-1.38, P < 0.001), respectively. Furthermore, the risk of MetS risk in pre- and postmenopausal women was increased 2.49-fold and 2.79-fold by a 1% increase in HbA1c level (OR 2.49; 95% CI, 1.97-3.16, P < 0.001) and (OR 2.79; 95% CI, 2.30-3.38, P < 0.001), respectively. High curry consumption reduced the risk of MetS significantly more than low curry consumption (OR 0.60; 95% CI, 0.39-0.91, P = 0.017) in premenopausal women. Furthermore, an increase in daily vitamin B2 intake by 1 mg reduced the risk of MetS by 45% (OR 0.55; 95% CI, 0.32-0.94, P = 0.028) in postmenopausal women. CONCLUSION Vitamin B2 and curry supplementation may protect against MetS. Further work is needed to reduce risk factors associated with heavy metals and determine the effects of vitamins and curry consumption on MetS during menopause.
Collapse
Affiliation(s)
- Hai Duc Nguyen
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon, Jeonnam, Republic of Korea
| | | |
Collapse
|
15
|
Association between heavy metals, high-sensitivity C-reaction protein and 10-year risk of cardiovascular diseases among adult Korean population. Sci Rep 2021; 11:14664. [PMID: 34282223 PMCID: PMC8289831 DOI: 10.1038/s41598-021-94158-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/30/2021] [Indexed: 02/06/2023] Open
Abstract
The prevalence of cardiovascular diseases (CVDs) in Korea tends to be increasing. It has worsened during the COVID-19 pandemic. Increasing evidence shows heavy metals are associated with increased CVD risk. We aimed to determine the association between the serum heavy metal levels and 10-year risk of CVDs and to predict risks of CVDs based on marginal effects. Heavy metals were measured by a graphite furnace atomic absorption spectrometry and direct mercury analyzer. The results show a significant relationship between the increase in cadmium, lead, mercury, hs-CRP levels and the 10-year risk of CVD after adjustment for serum cotinine, age group, sex, body mass index, a family history of CVDs, diabetes or hyperlipidemia, high-risk drinking, physical activity, and diabetes. A doubling of serum cadmium, lead, mercury, and hs-CRP was associated with the increase in the 10-year risk of CVD by 0.14%, 0.10%, 0.11% and 0.22%, respectively. Therefore, a special concern should be given to the harmful impacts of heavy metals on the 10-year risk of CVD. It is important to develop a prevention strategy targeting the high-risk population to slow down this progression to risk factors related to heavy metals and reduce prevalence. Remarkedly, hs-CRP is the most validated and widely used inflammatory marker, and could be a potential clinical value in predicting and monitoring CVDs.
Collapse
|
16
|
McCarty MF. Nutraceutical, Dietary, and Lifestyle Options for Prevention and Treatment of Ventricular Hypertrophy and Heart Failure. Int J Mol Sci 2021; 22:ijms22073321. [PMID: 33805039 PMCID: PMC8037104 DOI: 10.3390/ijms22073321] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 12/12/2022] Open
Abstract
Although well documented drug therapies are available for the management of ventricular hypertrophy (VH) and heart failure (HF), most patients nonetheless experience a downhill course, and further therapeutic measures are needed. Nutraceutical, dietary, and lifestyle measures may have particular merit in this regard, as they are currently available, relatively safe and inexpensive, and can lend themselves to primary prevention as well. A consideration of the pathogenic mechanisms underlying the VH/HF syndrome suggests that measures which control oxidative and endoplasmic reticulum (ER) stress, that support effective nitric oxide and hydrogen sulfide bioactivity, that prevent a reduction in cardiomyocyte pH, and that boost the production of protective hormones, such as fibroblast growth factor 21 (FGF21), while suppressing fibroblast growth factor 23 (FGF23) and marinobufagenin, may have utility for preventing and controlling this syndrome. Agents considered in this essay include phycocyanobilin, N-acetylcysteine, lipoic acid, ferulic acid, zinc, selenium, ubiquinol, astaxanthin, melatonin, tauroursodeoxycholic acid, berberine, citrulline, high-dose folate, cocoa flavanols, hawthorn extract, dietary nitrate, high-dose biotin, soy isoflavones, taurine, carnitine, magnesium orotate, EPA-rich fish oil, glycine, and copper. The potential advantages of whole-food plant-based diets, moderation in salt intake, avoidance of phosphate additives, and regular exercise training and sauna sessions are also discussed. There should be considerable scope for the development of functional foods and supplements which make it more convenient and affordable for patients to consume complementary combinations of the agents discussed here. Research Strategy: Key word searching of PubMed was employed to locate the research papers whose findings are cited in this essay.
Collapse
Affiliation(s)
- Mark F McCarty
- Catalytic Longevity Foundation, 811 B Nahant Ct., San Diego, CA 92109, USA
| |
Collapse
|
17
|
Nishijo M, Nogawa K, Suwazono Y, Kido T, Sakurai M, Nakagawa H. Lifetime Cadmium Exposure and Mortality for Renal Diseases in Residents of the Cadmium-Polluted Kakehashi River Basin in Japan. TOXICS 2020; 8:toxics8040081. [PMID: 33019764 PMCID: PMC7711806 DOI: 10.3390/toxics8040081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/24/2020] [Accepted: 09/25/2020] [Indexed: 01/23/2023]
Abstract
Very few studies have investigated the dose–response relationship between external cadmium (Cd) exposure and mortality. We aim to investigate the relationship between lifetime Cd intake (LCd) and mortality in the Cd-polluted Kakehashi River basin in Japan. Mortality risk ratios for a unit of increase of LCd and urinary Cd were analyzed using Cox’s proportional model. LCd was estimated based on residency and Cd in rice produced in their living areas. In men, mortality for all causes was significantly increased for a 10-μg/g Cr increase in urinary Cd, but not for a 1-g increase in LCd. In women, mortality risks for all causes and renal diseases, particularly renal failure, were significantly increased for a 10-μg/g Cr increase in urinary Cd. Similarly, mortality risks for renal diseases and renal failure were significantly increased for a 1-g increase of LCd in women. Comparing the contribution of two exposure markers to increased mortality in women, LCd was more effective for increasing mortality risks for renal diseases and renal failure, while urinary Cd contributed more to increased mortality risk for all causes. LCd may show a better dose–response relationship with mortality risk for renal diseases in women.
Collapse
Affiliation(s)
- Muneko Nishijo
- Department of Public Health, Kanazawa Medical University, Uchinada, Ishikawa 920-0293, Japan
- Correspondence: ; Tel.: +81-76-286-2211
| | - Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chuoku, Chiba 260-8670, Japan; (K.N.); (Y.S.)
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chuoku, Chiba 260-8670, Japan; (K.N.); (Y.S.)
| | - Teruhiko Kido
- Department of Community Health Nursing, School of Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-0942, Japan;
| | - Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Ishikawa 920-0293, Japan; (M.S.); (H.N.)
| | - Hideaki Nakagawa
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Ishikawa 920-0293, Japan; (M.S.); (H.N.)
| |
Collapse
|
18
|
Environmental cadmium exposure and noncancer mortality in a general Japanese population in cadmium nonpolluted regions. J Appl Toxicol 2020; 41:587-594. [DOI: 10.1002/jat.4067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 01/29/2023]
|
19
|
Sakurai M, Suwazono Y, Nishijo M, Nogawa K, Watanabe Y, Ishizaki M, Morikawa Y, Kido T, Nakagawa H. Relationship between urinary β 2 -microglobulin concentration and mortality in a cadmium-polluted area in Japan: A 35-year follow-up study. J Appl Toxicol 2020; 41:224-232. [PMID: 32667055 DOI: 10.1002/jat.4038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/19/2020] [Accepted: 06/24/2020] [Indexed: 01/14/2023]
Abstract
The relationship between urinary β2 -microglobulin (β2 -MG) and the risk of all-cause mortality and cause-specific mortality in a cadmium (Cd)-polluted area was investigated in 3139 inhabitants (1404 men and 1735 women) of the Kakehashi River basin in Japan at 35-year follow-up. The subjects had been participants in the 1981-1982 health impact survey that assessed Cd-induced renal dysfunction, as measured by the urinary β2 -MG concentration. Hazard ratios were calculated to assess the risk of all-cause and cause-specific mortality according to the urinary β2 -MG concentrations. Risk ratios (RRs) were assessed using the Fine and Gray regression model to account for competing risks of cause-specific mortality. The mortality rate was significantly higher in participants with urinary β2 -MG concentrations >1000 μg/g creatinine (Cr) for men and >300 μg/g Cr for women. In the proportional hazard model, higher urinary β2 -MG concentrations were associated with higher risks of circulatory disease, digestive system diseases, and kidney and urinary tract diseases in men and women, and with senility for women. However, when competing risk was accounted for, the RRs were significantly higher only for kidney and urinary tract diseases in men and women (RR for each increment of 1000 μg/g Cr [95% confidence interval]: 1.02 [1.00-1.04] for men, and 1.01 [1.00-1.02] for women). The long-term prognosis of participants with renal tubular dysfunction was poor, most likely due to kidney and renal tract diseases.
Collapse
Affiliation(s)
- Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Japan.,Health Evaluation Center, Kanazawa Medical University, Uchinada, Japan
| | - Yasushi Suwazono
- Department of Occupation and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Muneko Nishijo
- Department of Epidemiology and Public Health, Kanazawa Medical University, Uchinada, Japan
| | - Kazuhiro Nogawa
- Department of Occupation and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuuka Watanabe
- Department of Occupation and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masao Ishizaki
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Japan.,Health Evaluation Center, Kanazawa Medical University, Uchinada, Japan
| | - Yuko Morikawa
- School of Nursing, Kanazawa Medical University, Uchinada, Japan
| | - Teruhiko Kido
- School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Hideaki Nakagawa
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Japan
| |
Collapse
|
20
|
Watanabe Y, Nogawa K, Nishijo M, Sakurai M, Ishizaki M, Morikawa Y, Kido T, Nakagawa H, Suwazono Y. Relationship between cancer mortality and environmental cadmium exposure in the general Japanese population in cadmium non-polluted areas. Int J Hyg Environ Health 2020; 223:65-70. [DOI: 10.1016/j.ijheh.2019.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/27/2019] [Accepted: 10/10/2019] [Indexed: 11/27/2022]
|
21
|
Dyck KN, Bashir S, Horgan GW, Sneddon AA. Regular crabmeat consumers do not show increased urinary cadmium or beta-2-microglobulin levels compared to non-crabmeat consumers. J Trace Elem Med Biol 2019; 52:22-28. [PMID: 30732886 DOI: 10.1016/j.jtemb.2018.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/27/2018] [Accepted: 10/26/2018] [Indexed: 11/23/2022]
Abstract
Cadmium (Cd) is a toxic metal that can be relatively high in brown meat from crab and there is concern that it may accumulate in long-term crabmeat consumers posing a health risk. Sixteen healthy habitual crabmeat consumers and twenty five healthy non-crabmeat consumers were recruited through completion of a seafood frequency questionnaire. Whole blood and urine samples were analysed for Cd levels and urinary beta-2-microglobulin, an established marker of Cd-induced kidney toxicity, to determine levels in crabmeat consumers. Whole blood Cd levels were significantly elevated in the crabmeat-consuming group, whereas urinary levels of Cd and beta-2-microglobulin were not. Whole blood Cd levels can be both a short and long-term marker for Cd intake and levels might be expected to be elevated in the crabmeat consumers as crabmeat can contain Cd. However, crabmeat consumers did not show increases in a more established long-term marker of Cd (urinary Cd) and consistent with this, no change in a Cd-induced kidney toxicity marker. Consequently, in conclusion, compared to consumers who reported very little crabmeat consumption, healthy middle-aged consumers who regularly consume brown crabmeat products (an average of 447 g/week) for an average of 16 years showed no change in long-term Cd exposure or kidney toxicity.
Collapse
Affiliation(s)
- Karlee N Dyck
- The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Shabina Bashir
- The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Graham W Horgan
- Biomathematics and Statistics Scotland, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Alan A Sneddon
- The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK.
| |
Collapse
|
22
|
Nishijo M, Nakagawa H. Effects of Cadmium Exposure on Life Prognosis. CURRENT TOPICS IN ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE 2019. [DOI: 10.1007/978-981-13-3630-0_5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
23
|
Chowdhury R, Ramond A, O'Keeffe LM, Shahzad S, Kunutsor SK, Muka T, Gregson J, Willeit P, Warnakula S, Khan H, Chowdhury S, Gobin R, Franco OH, Di Angelantonio E. Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis. BMJ 2018; 362:k3310. [PMID: 30158148 PMCID: PMC6113772 DOI: 10.1136/bmj.k3310] [Citation(s) in RCA: 233] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/04/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis of epidemiological studies investigating the association of arsenic, lead, cadmium, mercury, and copper with cardiovascular disease. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Embase, and Web of Science searched up to December 2017. REVIEW METHODS Studies reporting risk estimates for total cardiovascular disease, coronary heart disease, and stroke for levels of arsenic, lead, cadmium, mercury, or copper were included. Two investigators independently extracted information on study characteristics and outcomes in accordance with PRISMA and MOOSE guidelines. Relative risks were standardised to a common scale and pooled across studies for each marker using random effects meta-analyses. RESULTS The review identified 37 unique studies comprising 348 259 non-overlapping participants, with 13 033 coronary heart disease, 4205 stroke, and 15 274 cardiovascular disease outcomes in aggregate. Comparing top versus bottom thirds of baseline levels, pooled relative risks for arsenic and lead were 1.30 (95% confidence interval 1.04 to 1.63) and 1.43 (1.16 to 1.76) for cardiovascular disease, 1.23 (1.04 to 1.45) and 1.85 (1.27 to 2.69) for coronary heart disease, and 1.15 (0.92 to 1.43) and 1.63 (1.14 to 2.34) for stroke. Relative risks for cadmium and copper were 1.33 (1.09 to 1.64) and 1.81 (1.05 to 3.11) for cardiovascular disease, 1.29 (0.98 to 1.71) and 2.22 (1.31 to 3.74) for coronary heart disease, and 1.72 (1.29 to 2.28) and 1.29 (0.77 to 2.17) for stroke. Mercury had no distinctive association with cardiovascular outcomes. There was a linear dose-response relation for arsenic, lead, and cadmium with cardiovascular disease outcomes. CONCLUSION Exposure to arsenic, lead, cadmium, and copper is associated with an increased risk of cardiovascular disease and coronary heart disease. Mercury is not associated with cardiovascular risk. These findings reinforce the importance of environmental toxic metals in cardiovascular risk, beyond the roles of conventional behavioural risk factors.
Collapse
Affiliation(s)
- Rajiv Chowdhury
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
| | - Anna Ramond
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
| | - Linda M O'Keeffe
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Bristol Population Health Science Institute, Bristol Medical School, Bristol, UK
| | - Sara Shahzad
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol, UK
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Bristol, UK
| | - Taulant Muka
- Institute of Social and Preventive Medicine, Bern, Switzerland
| | - John Gregson
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Peter Willeit
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Samantha Warnakula
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
| | | | - Susmita Chowdhury
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
| | | | - Oscar H Franco
- Institute of Social and Preventive Medicine, Bern, Switzerland
| | - Emanuele Di Angelantonio
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NHS Blood and Transplant, Cambridge, UK
| |
Collapse
|
24
|
Nogawa K, Suwazono Y, Nishijo M, Sakurai M, Ishizaki M, Morikawa Y, Watanabe Y, Kido T, Nakagawa H. Increase of lifetime cadmium intake dose-dependently increased all cause of mortality in female inhabitants of the cadmium-polluted Jinzu River basin, Toyama, Japan. ENVIRONMENTAL RESEARCH 2018; 164:379-384. [PMID: 29571127 DOI: 10.1016/j.envres.2018.03.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/05/2018] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Exposure to cadmium (Cd) via food is supposed to affect life prognosis of inhabitants of Cd-polluted area in Japan. However, there have been few reports demonstrating a significant relationship between the amount of Cd intake and mortality. We aimed to investigate the relationship between mortality and individual lifetime Cd intake (LCd) in inhabitants of the polluted Jinzu River basin, Toyama, Japan. METHODS We conducted a 26-year follow-up survey in 2407 inhabitants (1208 men and 1199 women) who participated in health examinations for screening of renal dysfunction from 1979 to 1984. The calculation of LCd in each inhabitant was based on the formula of Nogawa (Nogawa et al., 1989): (mean Cd concentration in rice of the present hamlet × 333.5 g/day + 34 μg/day) × 365 days/year × number of years of residence in the present hamlet + 50 μg/day × 365 days/year × number of years living in Cd non-polluted regions. In this formula, 333.5 g/day is the 1970 average daily intake of rice in this area, 34 µg/day is the Cd intake from foods other than rice in this area, and 50 μg/day is the average intake of Cd in non-polluted areas in Japan. Mortality risk ratios of LCd for all and specific causes were estimated after adjustments for age at baseline, smoking status, and history of hypertension using a Cox hazard model or Fine and Gray competing risks regression model. RESULTS The mortality risk ratios of LCd (+ 1 g) for all causes in women were significantly dose-dependently increased (risk ratio: 1.08). Relative risk of LCd for kidney and urinal tract disease, renal diseases, renal failure and toxic effects of cadmium were significantly higher in women. CONCLUSIONS The present study documents that individual LCd dose-dependently decreased life prognosis over long-term observation in women. LCd was significantly related to the increased mortality for renal disease and toxic effect of Cd in women. The result provides clear evidence that life prognosis was adversely affected by Cd-exposure, especially in women.
Collapse
Affiliation(s)
- Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba 260-8670, Japan.
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba 260-8670, Japan
| | - Muneko Nishijo
- Department of Epidemiology and Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchnada, Ishikawa 920-0293, Japan
| | - Masaru Sakurai
- Department of Social and Environmental Medicine, Health Evaluation Center, Kanazawa Medical University, 1-1 Daigaku, Uchnada, Ishikawa 920-0293, Japan
| | - Masao Ishizaki
- Department of Social and Environmental Medicine, Health Evaluation Center, Kanazawa Medical University, 1-1 Daigaku, Uchnada, Ishikawa 920-0293, Japan
| | - Yuko Morikawa
- School of Nursing, Kanazawa Medical University, 1-1 Daigaku, Uchnada, Ishikawa 920-0293, Japan
| | - Yuuka Watanabe
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba 260-8670, Japan
| | - Teruhiko Kido
- Department of Community Health Nursing, Kanazawa University School of Health Sciences, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
| | - Hideaki Nakagawa
- Medical Research Institute, Kanazawa Medical University, 1-1 Daigaku, Uchnada, Ishikawa 920-0293, Japan
| |
Collapse
|
25
|
Low-level cadmium exposure and cardiovascular outcomes in elderly Australian women: A cohort study. Int J Hyg Environ Health 2018; 221:347-354. [DOI: 10.1016/j.ijheh.2017.12.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 12/21/2022]
|
26
|
Nogawa K, Suwazono Y, Nishijo M, Sakurai M, Ishizaki M, Morikawa Y, Watanabe Y, Kido T, Nakagawa H. Relationship between mortality and rice cadmium concentration in inhabitants of the polluted Jinzu River basin, Toyama, Japan: A 26 year follow-up. J Appl Toxicol 2018; 38:855-861. [PMID: 29377184 DOI: 10.1002/jat.3593] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 12/04/2017] [Accepted: 12/18/2017] [Indexed: 11/09/2022]
Abstract
The aim of this study was to investigate the relationship between mortality and rice cadmium (Cd) concentration in inhabitants of a polluted area in Japan. The target subjects were inhabitants of the Jinzu River basin who participated in health examinations for screening of renal dysfunction from 1979 to 1984. The mean rice Cd concentration in each hamlet was used as an index of the Cd exposure. We conducted a 26 year follow-up survey in 3281 inhabitants (1544 men and 1737 women) whose data regarding the rice Cd concentration were available. Mortality risk ratios for all and specific causes were estimated after adjustments for age at baseline, smoking status and history of hypertension using a Cox hazard model or Fine and Gray competing risks regression model. The mortality risk ratios of rice Cd concentration (+0.1 ppm) for all causes in women were significantly increased (risk ratio: 1.04). Furthermore, the relative risks of rice Cd concentration for kidney and urinary tract disease, renal diseases, renal failure and toxic effects of cadmium were significantly increased in both sexes. These findings indicated that increased rice Cd concentration decreased the prognosis for life over a long-term observation in women. This result provides important information for determining the worldwide standard for allowable rice Cd concentration.
Collapse
Affiliation(s)
- Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba, 260-8670, Japan
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba, 260-8670, Japan
| | - Muneko Nishijo
- Department of Epidemiology and Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchnada, Ishikawa, 920-0293, Japan
| | - Masaru Sakurai
- Department of Social and Environmental Medicine, Health Evaluation Center, Kanazawa Medical University, 1-1 Daigaku, Uchnada, Ishikawa, 920-0293, Japan
| | - Masao Ishizaki
- Department of Social and Environmental Medicine, Health Evaluation Center, Kanazawa Medical University, 1-1 Daigaku, Uchnada, Ishikawa, 920-0293, Japan
| | - Yuko Morikawa
- Department of Epidemiology and Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchnada, Ishikawa, 920-0293, Japan
| | - Yuuka Watanabe
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba, 260-8670, Japan
| | - Teruhiko Kido
- Department of Community Health Nursing, Kanazawa University School of Health Sciences, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Hideaki Nakagawa
- Medical Research Institute, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan
| |
Collapse
|
27
|
Nordberg GF, Bernard A, Diamond GL, Duffus JH, Illing P, Nordberg M, Bergdahl IA, Jin T, Skerfving S. Risk assessment of effects of cadmium on human health (IUPAC Technical Report). PURE APPL CHEM 2018. [DOI: 10.1515/pac-2016-0910] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Abstract
Chemistry and Human Health, Division VII of the International Union on Pure and Applied Chemistry (IUPAC), provides guidance on risk assessment methodology and, as appropriate, assessment of risks to human health from chemicals of exceptional toxicity. The aim of this document is to describe dose-response relationships for the health effects of low-level exposure to cadmium, in particular, with an emphasis on causation. The term “cadmium” in this document includes all chemical species of cadmium, as well as those in cadmium compounds. Diet is the main source of cadmium exposure in the general population. Smokers and workers in cadmium industries have additional exposure. Adverse effects have been shown in populations with high industrial or environmental exposures. Epidemiological studies in general populations have also reported statistically significant associations with a number of adverse health effects at low exposures. Cadmium is recognized as a human carcinogen, a classification mainly based on occupational studies of lung cancer. Other cancers have been reported, but dose-response relationships cannot be defined. Cardiovascular disease has been associated with cadmium exposure in recent epidemiological studies, but more evidence is needed in order to establish causality. Adequate evidence of dose-response relationships is available for kidney effects. There is a relationship between cadmium exposure and kidney effects in terms of low molecular mass (LMM) proteinuria. Long-term cadmium exposures with urine cadmium of 2 nmol mmol−1 creatinine cause such effects in a susceptible part of the population. Higher exposures result in increases in the size of these effects. This assessment is supported by toxicokinetic and toxicodynamic (TKTD) modelling. Associations between urine cadmium lower than 2 nmol mmol−1 creatinine and LMM proteinuria are influenced by confounding by co-excretion of cadmium with protein. A number of epidemiological studies, including some on low exposures, have reported statistically significant associations between cadmium exposure and bone demineralization and fracture risk. Exposures leading to urine cadmium of 5 nmol mmol−1 creatinine and more increase the risk of bone effects. Similar associations at much lower urine cadmium levels have been reported. However, complexities in the cause and effect relationship mean that a no-effect level cannot be defined. LMM proteinuria was selected as the critical effect for cadmium, thus identifying the kidney cortex as the critical organ, although bone effects may occur at exposure levels similar to those giving rise to kidney effects. To avoid these effects, population exposures should not exceed that resulting in cadmium values in urine of more than 2 nmol mmol−1 creatinine. As cadmium is carcinogenic, a ‘safe’ exposure level cannot be defined. We therefore recommend that cadmium exposures be kept as low as possible. Because the safety margin for toxic effects in kidney and bone is small, or non-existent, in many populations around the world, there is a need to reduce cadmium pollution globally.
Collapse
Affiliation(s)
- Gunnar F. Nordberg
- Occupational and Environmental Medicine , Department of Public Health and Clinical Medicine , Umeå University , SE-90187 Umeå , Sweden
| | - Alfred Bernard
- Department of Toxicology , Catholic University of Louvain , Brussels , Belgium
| | | | - John H. Duffus
- The Edinburgh Centre for Toxicology , 43 Mansionhouse Road , Edinburgh EH9 2JD, Scotland , UK
| | | | - Monica Nordberg
- Institute of Environmental Medicine, Karolinska Institutet , Stockholm , Sweden
| | - Ingvar A. Bergdahl
- Occupational and Environmental Medicine , Department of Public Health and Clinical Medicine , Umeå University , SE-90187 Umeå , Sweden
| | - Taiyi Jin
- Department of Occupational Health and Toxicology , School of Public Health, Fudan University , Shanghai , China
| | - Staffan Skerfving
- Division of Occupational and Environmental Medicine, University Hospital , Lund , Sweden
| |
Collapse
|
28
|
Benedetti M, De Santis M, Manno V, Minerba S, Mincuzzi A, Morabito A, Panocchia N, Soggiu ME, Tanzarella A, Pastore T, Bossola M, Giua R, Leogrande S, Nocioni A, Conti S, Comba P. Spatial distribution of kidney disease in the contaminated site of Taranto (Italy). Am J Ind Med 2017; 60:1088-1099. [PMID: 29027241 DOI: 10.1002/ajim.22781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Exposure to heavy metals has been associated with kidney disease. We investigated the spatial distribution of kidney disease in the industrially contaminated site of Taranto. METHODS Cases were subjects with a first hospital discharge diagnosis of kidney disease. Cases affected by specific comorbidities were excluded. Standardized Hospitalization Ratios (SHRs) were computed for low/high exposure area and for modeled spatial distribution of cadmium and fine particulate matter. RESULT Using the high/low exposure approach, in subjects aged 20-59 years residing in the high exposure area a significant excess of hospitalization was observed in males and a non-significant excess in females. No excesses were observed in subjects aged 60 years and over. The analysis by the modeling approach did not show a significant association with the greatest pollution impact area. CONCLUSION Due to the excesses of hospitalization observed in the high/low exposure approach, a continuing epidemiological surveillance of residents and occupational groups is warranted.
Collapse
Affiliation(s)
- Marta Benedetti
- Department of Environment and Health (DAMSA); Istituto Superiore di Sanità; Rome Italy
| | - Marco De Santis
- Department of Environment and Health (DAMSA); Istituto Superiore di Sanità; Rome Italy
| | - Valerio Manno
- Unit of Statistics; Istituto Superiore di Sanità; Rome Italy
| | - Sante Minerba
- Epidemiological and Statistical Unit; Azienda Sanitaria Locale Taranto; Taranto Italy
| | - Antonella Mincuzzi
- Epidemiological and Statistical Unit; Azienda Sanitaria Locale Taranto; Taranto Italy
| | - Angela Morabito
- Apulia Region Environmental Protection Agency (ARPA PUGLIA); Bari Italy
| | - Nicola Panocchia
- Haemodialysis Service; Department of Surgery; Università Cattoloca del Sacro Cuore; Rome Italy
| | - Maria Eleonora Soggiu
- Department of Environment and Health (DAMSA); Istituto Superiore di Sanità; Rome Italy
| | | | - Tiziano Pastore
- Apulia Region Environmental Protection Agency (ARPA PUGLIA); Bari Italy
| | - Maurizio Bossola
- Haemodialysis Service; Department of Surgery; Università Cattoloca del Sacro Cuore; Rome Italy
| | - Roberto Giua
- Apulia Region Environmental Protection Agency (ARPA PUGLIA); Bari Italy
| | - Simona Leogrande
- Epidemiological and Statistical Unit; Azienda Sanitaria Locale Taranto; Taranto Italy
| | | | - Susanna Conti
- Unit of Statistics; Istituto Superiore di Sanità; Rome Italy
| | - Pietro Comba
- Department of Environment and Health (DAMSA); Istituto Superiore di Sanità; Rome Italy
| |
Collapse
|
29
|
Wen L, Yuan Q, Sun M, Niu M, Wang H, Fu H, Zhou F, Yao C, Wang X, Li Z, He Z. Generation and characteristics of human Sertoli cell line immortalized by overexpression of human telomerase. Oncotarget 2017; 8:16553-16570. [PMID: 28152522 PMCID: PMC5369984 DOI: 10.18632/oncotarget.14985] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 01/24/2017] [Indexed: 12/25/2022] Open
Abstract
Sertoli cells are required for normal spermatogenesis and they can be reprogrammed to other types of functional cells. However, the number of primary Sertoli cells is rare and human Sertoli cell line is unavailable. In this study, we have for the first time reported a stable human Sertoli cell line, namely hS1 cells, by overexpression of human telomerase. The hS1 cells expressed a number of hallmarks for human Sertoli cells, including SOX9, WT1, GDNF, SCF, BMP4, BMP6, GATA4, and VIM, and they were negative for 3β-HSD, SMA, and VASA. Higher levels of AR and FSHR were observed in hS1 cells compared to primary human Sertoli cells. Microarray analysis showed that 70.4% of global gene profiles of hS1 cells were similar to primary human Sertoli cells. Proliferation assay demonstrated that hS1 cells proliferated rapidly and they could be passaged for more than 30 times in 6 months. Neither Y chromosome microdeletion nor tumorgenesis was detected in this cell line and 90% normal karyotypes existed in hS1 cells. Collectively, we have established the first human Sertoli cell line with phenotype of primary human Sertoli cells, an unlimited proliferation potential and high safety, which could offer sufficient human Sertoli cells for basic research as well as reproductive and regenerative medicine.
Collapse
Affiliation(s)
- Liping Wen
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Qingqing Yuan
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Min Sun
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Minghui Niu
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Hong Wang
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Hongyong Fu
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Fan Zhou
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Chencheng Yao
- Department of Andrology, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Xiaobo Wang
- Department of Andrology, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Zheng Li
- Department of Andrology, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Zuping He
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.,Shanghai Institute of Andrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China.,Shanghai Key Laboratory of Assisted Reproduction and Reproductive Genetics, Shanghai 200127, China.,Shanghai Key Laboratory of Reproductive Medicine, Shanghai 200025, China
| |
Collapse
|
30
|
Phuc HD, Kido T, Oanh NTP, Manh HD, Anh LT, Oyama Y, Okamoto R, Ichimori A, Nogawa K, Suwazono Y, Nakagawa H. Effects of aging on cadmium concentrations and renal dysfunction in inhabitants in cadmium-polluted regions in Japan. J Appl Toxicol 2017; 37:1046-1052. [DOI: 10.1002/jat.3455] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/18/2017] [Accepted: 01/18/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Hoang Duc Phuc
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Teruhiko Kido
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Nguyen Thi Phuong Oanh
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Ho Dung Manh
- Faculty of Pharmacy; Lac Hong University; No. 10, Huynh Van Nghe Bien Hoa Dong Nai Vietnam
| | - Le Thai Anh
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Yuko Oyama
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Rie Okamoto
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Akie Ichimori
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences; Kanazawa University; 5-11-80 Kodatsuno Kanazawa Ishikawa Japan
| | - Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine; Chiba University; 1-8-1, Inohana, Chuoku Chiba Japan
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine; Chiba University; 1-8-1, Inohana, Chuoku Chiba Japan
| | - Hideaki Nakagawa
- Department of Epidemiology and Public Health; Kanazawa Medical University; 1-1 Daigaku Uchinada Ishikawa Japan
| |
Collapse
|
31
|
Effect of cadmium on bone tissue in growing animals. ACTA ACUST UNITED AC 2016; 68:391-7. [PMID: 27312893 DOI: 10.1016/j.etp.2016.06.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 05/20/2016] [Accepted: 06/01/2016] [Indexed: 11/22/2022]
Abstract
Accumulation of cadmium (Cd), an extremely toxic metal, can cause renal failure, decreased vitamin D synthesis, and consequently osteoporosis. The aim of this work was to evaluate the effect of Cd on two types of bone in growing Wistar rats. Sixteen 21-day-old male Wistar rats were assigned to one of two groups. The Cd group subcutaneously received 0.5mg/kg of CdCl2 5 times weekly for 3 months. The control group similarly received bidistilled water. Following euthanasia, the mandibles and tibiae were resected, fixed, decalcified and processed histologically to obtain sections for H&E and tartrate-resistant acid phosphatase (TRAP) staining. Photomicrographs were used to determine bone volume (BV/TV%), total growth cartilage width (GPC.Wi) hypertrophic cartilage width (HpZ.Wi), percentage of yellow bone marrow (%YBM), megakaryocyte number (N.Mks/mm(2)), and TRAP+osteoclast number (N.TRAP+Ocl/mm(2)). Results were statistically analyzed using Student's t test. Cd exposed animals showed a significant decrease in subchondral bone volume and a significant increase in TRAP+ osteoclast number and percentage of yellow bone marrow in the tibia, and an increase in megakaryocyte number in mandibular interradicular bone. No significant differences were observed in the remaining parameters. The results obtained with this experimental design show that Cd would seemingly have a different effect on subchondral and interradicular bone. The decrease in bone volume and increase in tibial yellow bone marrow suggest that cadmium inhibits differentiation of mesenchymal cells to osteoblasts, favoring differentiation into adipocytes. The different effects of Cd on interradicular bone might be due to the protective effect of the mastication forces.
Collapse
|
32
|
Santos-Gallego CG, Jialal I. Cadmium and atherosclerosis: Heavy metal or singing the blues? Atherosclerosis 2016; 249:230-2. [DOI: 10.1016/j.atherosclerosis.2016.01.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 01/26/2016] [Indexed: 12/15/2022]
|
33
|
Lee CC, Weng CH, Huang WH, Yen TH, Lin JL, Lin-Tan DT, Chen KH, Hsu CW. Association Between Blood Cadmium Levels and Mortality in Peritoneal Dialysis. Medicine (Baltimore) 2016; 95:e3717. [PMID: 27175714 PMCID: PMC4902556 DOI: 10.1097/md.0000000000003717] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The negative impact of environmental exposure of cadmium has been well established in the general population. However, the effect of cadmium exposure in chronic peritoneal dialysis (PD) patients remains uncertain.A total of 306 chronic PD patients were included in this 36-month observational study. Patients were stratified into 3 groups by the tertile of baseline blood cadmium levels (BCLs): high (>0.244 μg/L, n = 101), middle (0.130-0.244 μg/L, n = 102), and low (<0.130 μg/L, n = 103) for cross-sectional analyses. Mortality rates and cause of death were recorded for longitudinal analyses.Patients in the high-BCL group were older, more likely to have diabetes mellitus, had lower levels of serum albumin and lower percentage of lean body mass than patients in the low-BCL group. A multivariate logistic regression analysis revealed that logarithmic transformed BCL was independently associated with a higher risk of low turnover bone disease (odds ratio = 3.8, P = 0.005). At the end of the 36-month follow-up, 66 (21.6%) patients died. Mortality rates increased with higher BCLs (P for trend = 0.005). A Cox multivariate analysis showed that, using the low-BCL group as the reference, the high-BCL group had increased hazard ratios (HR) for all-cause mortality in chronic PD patients after adjusting for related variables (HR = 2.469, 95% confidence interval = 1.078-5.650, P = 0.043).In conclusion, BCL showed significant association with malnutrition and low turnover bone disease in chronic PD patients. Furthermore, BCL is an important determinant of mortality. Our findings suggest that avoiding environmental exposure to cadmium as much as possible is warranted in chronic PD patients.
Collapse
Affiliation(s)
- Cheng-Chia Lee
- From the Department of Nephrology and Division of Clinical Toxicology (C-CL, C-HW, W-HH, T-HY, J-LL, D-LT, K-HC, C-WH), Chang Gung Memorial Hospital, Taipei; Department of Nephrology and Division of Clinical Toxicology (C-CL, C-HW, W-HH, T-HY, J-LL, D-LT, K-HC, C-WH), Lin-Kou Medical Center, Taoyuan; and Chang Gung University and School of Medicine (C-CL, C-HW, W-HH, T-HY, J-LL, D-LT, K-HC, C-WH), Taipei, Taiwan, ROC
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Duc Phuc H, Kido T, Dung Manh H, Thai Anh L, Phuong Oanh NT, Okamoto R, Ichimori A, Nogawa K, Suwazono Y, Nakagawa H. A 28-year observational study of urinary cadmium and β 2 -microglobulin concentrations in inhabitants in cadmium-polluted areas in Japan. J Appl Toxicol 2016; 36:1622-1628. [PMID: 27080698 DOI: 10.1002/jat.3327] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 02/29/2016] [Accepted: 02/29/2016] [Indexed: 11/10/2022]
Abstract
The biological half-life of cadmium (Cd) is as long as 10-30 years. Exposure to this element induces renal tubular dysfunction, which is considered irreversible. β2 -microglobulin (β2 -MG) is a low-molecular-weight protein, and urinary β2 -MG is one of the most useful and critical indicators for the early detection of renal tubular dysfunction. However, very little research has been published concerning the long-term observation of Cd-induced adverse health effects. As such, this follow-up study was conducted for 28 years to clarify the relationship between the concentration of Cd and β2 -MG in the urine of 28 inhabitants (14 male and 14 female) living in the Kakehashi River basin, Ishikawa prefecture (Japan), previously one of the most highly Cd-polluted regions in this country. All subjects were over 60 years old in 2014 and participated in all six health examinations conducted over 28 years (1986-2014). Urine was collected at the appropriate time and kept frozen to analyze urinary Cd and β2 -MG concentrations. The urinary Cd concentration was found to decrease by nearly half between 1986 and 2008 in both male and female subjects, whereas it increased significantly from 2008 to 2014 in males. In contrast, urinary β2 -MG concentrations tended to increase over the 28-year study period in both sexes. Urinary Cd and β2 -MG concentrations in females were significantly higher than those in males in this Cd-polluted region. Age is more strongly associated with urinary β2 -MG concentration than recent Cd body burden. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Hoang Duc Phuc
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, Japan
| | - Teruhiko Kido
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, Japan.
| | - Ho Dung Manh
- Faculty of Pharmacy, Lac Hong University, No. 10, Huynh Van Nghe, Bien Hoa, Dong Nai, Vietnam
| | - Le Thai Anh
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, Japan
| | - Nguyen Thi Phuong Oanh
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, Japan
| | - Rie Okamoto
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, Japan
| | - Akie Ichimori
- Faculty of Health Sciences, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, Japan
| | - Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuoku, Chiba, Japan
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuoku, Chiba, Japan
| | - Hideaki Nakagawa
- Department of Epidemiology and Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, Japan
| |
Collapse
|
35
|
Byber K, Lison D, Verougstraete V, Dressel H, Hotz P. Cadmium or cadmium compounds and chronic kidney disease in workers and the general population: a systematic review. Crit Rev Toxicol 2015; 46:191-240. [DOI: 10.3109/10408444.2015.1076375] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
36
|
Ke S, Cheng XY, Zhang JY, Jia WJ, Li H, Luo HF, Ge PH, Liu ZM, Wang HM, He JS, Chen ZN. Estimation of the benchmark dose of urinary cadmium as the reference level for renal dysfunction: a large sample study in five cadmium polluted areas in China. BMC Public Health 2015; 15:656. [PMID: 26169263 PMCID: PMC4499937 DOI: 10.1186/s12889-015-2021-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 07/06/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Itai-itai disease primarily results from cadmium (Cd) exposure and is known as one of the four major pollution diseases in Japan. Cd pollution is more serious in several areas of China than in Japan. However, there is still a lack of information regarding the threshold level of Cd exposure for the adverse health effects in the general Chinese population. This study aims to evaluate the reference value of urinary Cd (UCd) for renal dysfunction in a Chinese population as the benchmark dose lower confidence limit (BMDL) based on a large sample survey. METHODS A total of 6103 participants who lived in five Cd polluted areas of China participated in this study. We analyzed UCd levels as a biomarker of exposure and urinary β2-microglobulin (Uβ2-MG) levels as a renal tubular effect biomarker. The BMD studies were performed using BMD software. The benchmark response (BMR) was defined as a 10% additional risk above the background. RESULTS There was a positive correlation between the UCd levels and the prevalence of Uβ2-MG. The BMD of UCd for Uβ2-MG was estimated for each province. The findings showed that the BMD levels were related to the participants' geographic region, which may be partially due to the large differences in Cd exposure level, ethnic group, lifestyle and diet of the sample population in these study areas. The reference level of UCd for the renal effects was further evaluated by combining the five sets of data from all 6103 subjects. The overall BMDLs of UCd for Uβ2-MG with an excess risk of 10% were 2.00 μg/g creatinine (μg/g cr) in males and 1.69 μg/g cr in females, which were significantly lower than the World Health Organization (WHO) threshold level of 5 μg/g cr for Cd-related renal effects. CONCLUSIONS The selection of the sample population and geographic region affected the BMDL evaluation. Based on the findings of this survey of a large sample population, the UCd BMDLs for Uβ2-MG in males with BMRs at 10% were 2.00 μg/g cr. The BMD was slightly lower in females, which indicated that females may be relatively more sensitive to Cd exposure than males.
Collapse
Affiliation(s)
- Shen Ke
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Xi-Yu Cheng
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Jie-Ying Zhang
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Wen-Jing Jia
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Hao Li
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Hui-Fang Luo
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Peng-He Ge
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Ze-Min Liu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, People's Republic of China.
| | - Hong-Mei Wang
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, People's Republic of China.
| | - Jin-Sheng He
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Zhi-Nan Chen
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| |
Collapse
|
37
|
Suwazono Y, Nogawa K, Morikawa Y, Nishijo M, Kobayashi E, Kido T, Nakagawa H, Nogawa K. Renal tubular dysfunction increases mortality in the Japanese general population living in cadmium non-polluted areas. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2015; 25:399-404. [PMID: 24938509 DOI: 10.1038/jes.2014.44] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 04/02/2014] [Accepted: 04/11/2014] [Indexed: 06/03/2023]
Abstract
The aim of this study was to establish the cause-effect relationship between renal tubular dysfunction and mortality. A 19-year cohort study was conducted in 900 men and 1313 women in 1993 or 1994 who lived in two cadmium non-polluted areas in Japan. Hazard ratio (HR) and 95% confidence interval (95% CI) of urinary β2-microglobulin (β2-MG) and N-acetyl-β-glucosaminidase (NAG) for mortality were calculated using a proportional hazard regression. Forward stepwise model selection was applied to the potential covariates such as age, body mass index, mean arterial pressure, various lifestyle factors and present illness. Simultaneously, the dose-effect relationship between renal tubular markers and urinary cadmium at baseline was evaluated using multiple regression analyses. In men, HR was significant for β2-MG (HR corresponding to an increase of 100 μg/g cre: 1.02) and NAG (HR corresponding to an increase of 1 IU/g cre: 1.05). In women, a significant HR was observed for β2-MG (HR corresponding to an increase of 100 μg/g cre: 1.01) and NAG (HR corresponding to an increase of 1 IU/g cre: 1.02). Dose-effect relationships were significant for urinary cadmium and all renal tubular markers in men and women. The present study indicated that renal tubular dysfunction was significantly related to mortality in the general population of cadmium non-polluted areas in Japan.
Collapse
Affiliation(s)
- Yasushi Suwazono
- 1] Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan [2] Center for Preventive Medical Science, Chiba University, Chiba, Japan
| | - Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuko Morikawa
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Muneko Nishijo
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Etsuko Kobayashi
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Teruhiko Kido
- Department of Community Health Nursing, Kanazawa University School of Health Sciences, Ishikawa, Japan
| | - Hideaki Nakagawa
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Koji Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| |
Collapse
|
38
|
Nawrot TS, Martens DS, Hara A, Plusquin M, Vangronsveld J, Roels HA, Staessen JA. Association of total cancer and lung cancer with environmental exposure to cadmium: the meta-analytical evidence. Cancer Causes Control 2015; 26:1281-8. [PMID: 26109463 DOI: 10.1007/s10552-015-0621-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 06/12/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Recent studies are indicative of substantial progress in understanding the dose-response relation between the incidence of total and lung cancer and environmental cadmium exposure. We conducted a meta-analysis of population studies that examined the risk of cancer in relation to lifetime exposure to cadmium. METHODS We searched MEDLINE, Web of Science, and relevant reviews until August 2014 for studies on the association between cancer risk and cadmium exposure. Eligible studies had to include an estimate of lifetime exposure to cadmium as reflected by the urinary cadmium concentration and adjustment of the cancer risk at least for age and smoking. We pooled relative risk across the studies estimates for cancer and lung cancer using variance-weighted random-effect models and expressed association sizes for a twofold increase in urinary cadmium, thereby respecting the continuous nature of the association. RESULTS The meta-analysis included 20,459 participants from three prospective population studies. The average urinary cadmium concentration across populations ranged from 0.25 to 0.93 µg/g creatinine. The relative risk of total cancer, associated with a doubling of the urinary cadmium concentration, ranged across the different studies from 1.18 to 1.31, and the pooled relative risk was 1.22 (95% CI 1.13-1.31; p < 0.0001). For lung cancer, the relative risk ranged from 1.21 to 1.70 for a doubling of the urinary cadmium concentration, while the pooled relative risk amounted to 1.68 (1.47-1.92; p < 0.0001). Excluding one study at the time did not move the pooled estimates outside the confidence interval of the overall estimate for all studies combined. CONCLUSION The epidemiological evidence of the last decade consistently identifies low-level environmental exposure to cadmium as a risk factor for total cancer and lung cancer.
Collapse
Affiliation(s)
- Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium,
| | | | | | | | | | | | | |
Collapse
|
39
|
Larsson SC, Wolk A. Urinary cadmium and mortality from all causes, cancer and cardiovascular disease in the general population: systematic review and meta-analysis of cohort studies. Int J Epidemiol 2015; 45:782-91. [PMID: 25997435 DOI: 10.1093/ije/dyv086] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Cadmium is a toxic heavy metal distributed in the environment. We conducted a systematic review and meta-analysis to examine the association between urinary cadmium concentration and mortality from all causes, cancer and cardiovascular disease (CVD) in the general population. METHODS Studies were identified by searching PubMed and Embase (to 30 March 2015) and the reference lists of retrieved articles. We included prospective studies that reported hazard ratios (HR) with 95% confidence intervals (CI) for the association between urinary cadmium concentration and all-cause, cancer or CVD mortality. A random-effects model was used to combine study-specific results. RESULTS Nine cohort studies, including 5600 deaths from all causes, 1332 deaths from cancer and 1715 deaths from CVD, were eligible for inclusion in the meta-analysis. The overall HRs for the highest vs lowest category of urinary cadmium were1.44 (95% CI, 1.25-1.64; I(2 )= 40.5%) for all-cause mortality (six studies), 1.39 (95% CI, 0.96-1.99; I(2 )= 75.9%) for cancer mortality (four studies) and 1.57 (95% CI, 1.27-1.95; I(2 )= 34.0%) for CVD mortality (five studies). In an analysis restricted to six cohort studies conducted in populations with a mean urinary cadmium concentration of ≤1 µg/g creatinine, the HRs were 1.38 (95% CI, 1.17-1.63; I(2 )= 48.3%) for all-cause mortality, 1.56 (95% CI, 0.98-2.47; I(2 )= 81.0%) for cancer mortality and 1.50 (95% CI, 1.18-1.91; I(2 )= 38.2%) for CVD mortality. CONCLUSIONS Even at low-level exposure, cadmium appears to be associated with increased mortality. Further large prospective studies of cadmium exposure and mortality are warranted.
Collapse
Affiliation(s)
- Susanna C Larsson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
40
|
Sherief LM, Abdelkhalek ER, Gharieb AF, Sherbiny HS, Usef DM, Almalky MAA, Kamal NM, Salama MA, Gohar W. Cadmium status among pediatric cancer patients in Egypt. Medicine (Baltimore) 2015; 94:e740. [PMID: 25997039 PMCID: PMC4602885 DOI: 10.1097/md.0000000000000740] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Cadmium (Cd) is a toxic, nonessential, and bio-accumulating heavy metal widely used in industry. Several studies have suggested a positive association between Cd exposure and risks of several cancers. However, data from general population, especially children are sparse.In the current cross-sectional case-control study, we aimed to assess the association between Cd exposure, as expressed by Cd body status (blood, urine, scalp hair, and nails) and cancer among Egyptian children. Three hundred and fifty pediatric cancer cases aged 3 to 14-years old were enrolled in our study. Their body Cd levels were evaluated using Atomic Absorption Spectrophometer and were compared with Cd levels of 350 healthy children.Significantly higher Cd levels (blood, urine, scalp hair, and nails) were documented in cancer cases when compared with control (P < 0.001). Such difference was still detected when comparing each malignant type separately, with controls. Tobacco smoke exposure, rural residence, and low socioeconomic status were reported more frequently among cases than comparisons.Positive association between Cd exposure and pediatric malignancy may be present.
Collapse
Affiliation(s)
- Laila M Sherief
- From the Department of Pediatrics, Faculty of Medicine, Zagazig (LMS, ERA, HSS, DMU, MAAA, WG); Cairo (NMK); Benha Universities (MAS); Benha children Hospital, Benha (LMS, ERA, MAS); and Department of Biochemistry, Zagazig University, Zagazig, Egypt (AFG)
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Ke S, Cheng XY, Li H, Jia WJ, Zhang JY, Luo HF, Wang ZL, Chen ZN. Body burden of cadmium and its related factors: a large-scale survey in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 511:649-654. [PMID: 25594907 DOI: 10.1016/j.scitotenv.2015.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 01/06/2015] [Accepted: 01/07/2015] [Indexed: 06/04/2023]
Abstract
A survey of more than 6000 participants from four distinct non-polluted and polluted regions in China was conducted to evaluate the body burden of cadmium (Cd) on the Chinese populations using urinary Cd (UCd) as a biomarker. The findings revealed that the UCd level was 1.24 μg/g creatinine (μg/g cr) for the sample population from non-polluted Shanghai, and the UCd levels exceeded 5 μg/g cr, which is the health-based exposure limit set by the World Health Organization (WHO), in 1.1% of people. The mean UCd levels in moderately polluted (Hubei and Liaoning) and highly polluted areas (Guizhou) were 4.69 μg/g cr, 3.62 μg/g cr and 6.08 μg/g cr, respectively, and these levels were 2.9 to 4.9 times the levels observed in Shanghai. Notably, the UCd levels exceeded the recently updated human biomonitoring II values (i.e., intervention or "action level") in 44.8%-87.9% of people from these areas compared to only 5.1%-21.4% of people in Shanghai. The corresponding prevalence of elevated UCd levels (>WHO threshold, 5 μg/g cr) was also significantly higher (30.7% to 63.8% vs. 1.1%), which indicates that elevated Cd-induced health risks to residents in these areas. Age and region were significant determinants for UCd levels in a population, whereas gender did not significantly influence UCd.
Collapse
Affiliation(s)
- Shen Ke
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China
| | - Xi-Yu Cheng
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China
| | - Hao Li
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China
| | - Wen-Jing Jia
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China
| | - Jie-Ying Zhang
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China
| | - Hui-Fang Luo
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China
| | - Zi-Ling Wang
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China
| | - Zhi-Nan Chen
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China.
| |
Collapse
|
42
|
All-cause mortality increased by environmental cadmium exposure in the Japanese general population in cadmium non-polluted areas. J Appl Toxicol 2014; 35:817-23. [DOI: 10.1002/jat.3077] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 08/31/2014] [Accepted: 09/01/2014] [Indexed: 02/04/2023]
|
43
|
Solenkova NV, Newman JD, Berger JS, Thurston G, Hochman JS, Lamas GA. Metal pollutants and cardiovascular disease: mechanisms and consequences of exposure. Am Heart J 2014; 168:812-22. [PMID: 25458643 PMCID: PMC4254412 DOI: 10.1016/j.ahj.2014.07.007] [Citation(s) in RCA: 182] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 07/11/2014] [Indexed: 02/05/2023]
Abstract
INTRODUCTION There is epidemiological evidence that metal contaminants may play a role in the development of atherosclerosis and its complications. Moreover, a recent clinical trial of a metal chelator had a surprisingly positive result in reducing cardiovascular events in a secondary prevention population, strengthening the link between metal exposure and cardiovascular disease (CVD). This is, therefore, an opportune moment to review evidence that exposure to metal pollutants, such as arsenic, lead, cadmium, and mercury, is a significant risk factor for CVD. METHODS We reviewed the English-speaking medical literature to assess and present the epidemiological evidence that 4 metals having no role in the human body (xenobiotic), mercury, lead, cadmium, and arsenic, have epidemiologic and mechanistic links to atherosclerosis and CVD. Moreover, we briefly review how the results of the Trial to Assess Chelation Therapy (TACT) strengthen the link between atherosclerosis and xenobiotic metal contamination in humans. CONCLUSIONS There is strong evidence that xenobiotic metal contamination is linked to atherosclerotic disease and is a modifiable risk factor.
Collapse
Affiliation(s)
| | - Jonathan D Newman
- Leon H Charney Division of Cardiology, New York University School of Medicine, New York, NY
| | - Jeffrey S Berger
- Leon H Charney Division of Cardiology, New York University School of Medicine, New York, NY
| | - George Thurston
- Nelson Institute of Environmental Medicine, New York University School of Medicine, New York, NY
| | - Judith S Hochman
- Leon H Charney Division of Cardiology, New York University School of Medicine, New York, NY
| | - Gervasio A Lamas
- Department of Medicine, Mount Sinai Medical Center, Miami Beach, FL; Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach FL
| |
Collapse
|
44
|
Dietary cadmium exposure and chronic kidney disease: A population-based prospective cohort study of men and women. Int J Hyg Environ Health 2014; 217:720-5. [DOI: 10.1016/j.ijheh.2014.03.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 02/28/2014] [Accepted: 03/06/2014] [Indexed: 11/18/2022]
|
45
|
Suwazono Y, Nogawa K, Morikawa Y, Nishijo M, Kobayashi E, Kido T, Nakagawa H, Nogawa K. Impact of urinary cadmium on mortality in the Japanese general population in cadmium non-polluted areas. Int J Hyg Environ Health 2014; 217:807-12. [PMID: 24924827 DOI: 10.1016/j.ijheh.2014.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 04/14/2014] [Accepted: 05/04/2014] [Indexed: 01/31/2023]
Abstract
PURPOSE The aim of the present study was to evaluate the dose-effect relationship between urinary cadmium (U-Cd as an index of internal Cd exposure) and mortality in a cohort of the Japanese general population. METHODS A 19-year cohort study was conducted in 897 men and 1307 women who lived in two non-polluted areas in Japan. The subjects were categorized into four quartiles based on creatinine adjusted U-Cd (μg/g cre). Hazard ratio (HR) and 95% confidence interval (95%CI) of the quartiles of U-Cd for mortality was calculated using a proportional hazards regression. Forward stepwise model selection was applied to the potential covariates such as age, body mass index, mean arterial pressure, various lifestyle factors and present illness. RESULTS The mortality rates per 1000 person years were 27.8 and 12.5 in men and women, respectively. In men, the fourth quartile of U-Cd (≥ 2.919 μg/g cre) showed a significant, positive HR (1.50, 95%CI: 1.11-2.02) for mortality compared to the first quartile (< 1.014). In women, the fourth quartile of U-Cd (≥ 3.943 μg/g cre) also showed a significant HR (1.50, 95%CI: 1.08-2.09) for mortality compared to the first quartile (< 1.140). CONCLUSION The present study clarified that U-Cd was significantly associated with increased mortality, indicating the worsened life prognosis of the general population in Cd non-polluted areas in Japan. These results highlight the importance of further discussion of the health risk assessment of Cd exposure in the general population.
Collapse
Affiliation(s)
- Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba 260-8670, Japan.
| | - Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba 260-8670, Japan
| | - Yuko Morikawa
- Department of Epidemiology and Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchnada, Ishikawa 920-0293, Japan
| | - Muneko Nishijo
- Department of Epidemiology and Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchnada, Ishikawa 920-0293, Japan
| | - Etsuko Kobayashi
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba 260-8670, Japan
| | - Teruhiko Kido
- Department of Community Health Nursing, Kanazawa University School of Health Sciences, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
| | - Hideaki Nakagawa
- Department of Epidemiology and Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchnada, Ishikawa 920-0293, Japan
| | - Koji Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba 260-8670, Japan
| |
Collapse
|
46
|
Åkesson A, Barregard L, Bergdahl IA, Nordberg GF, Nordberg M, Skerfving S. Non-renal effects and the risk assessment of environmental cadmium exposure. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:431-8. [PMID: 24569905 PMCID: PMC4014752 DOI: 10.1289/ehp.1307110] [Citation(s) in RCA: 183] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 02/22/2014] [Indexed: 05/19/2023]
Abstract
BACKGROUND Exposure to cadmium (Cd) has long been recognized as a health hazard, both in industry and in general populations with high exposure. Under the currently prevailing health risk assessment, the relationship between urinary Cd (U-Cd) concentrations and tubular proteinuria is used. However, doubts have recently been raised regarding the justification of basing the risk assessment on this relationship at very low exposure. OBJECTIVES Our objective was to review available information on health effects of Cd exposure with respect to human health risk assessment. DISCUSSION The associations between U-Cd and urinary proteins at very low exposure may not be due to Cd toxicity, and the clinical significance of slight proteinuria may also be limited. More importantly, other effects have been reported at very low Cd exposure. There is reason to challenge the basis of the existing health risk assessment for Cd. Our review of the literature found that exposure to low concentrations of Cd is associated with effects on bone, including increased risk of osteoporosis and fractures, and that this observation has implications for the health risk assessment of Cd. Other effects associated with Cd should also be considered, in particular cancer, although the information is still too limited for appropriate use in quantitative risk assessment. CONCLUSION Non-renal effects should be considered critical effects in the health risk assessment of Cd.
Collapse
Affiliation(s)
- Agneta Åkesson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | | | | |
Collapse
|
47
|
Cadmium exposure and clinical cardiovascular disease: a systematic review. Curr Atheroscler Rep 2014; 15:356. [PMID: 23955722 DOI: 10.1007/s11883-013-0356-2] [Citation(s) in RCA: 170] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Mounting evidence supports that cadmium, a toxic metal found in tobacco, air and food, is a cardiovascular risk factor. Our objective was to conduct a systematic review of epidemiologic studies evaluating the association between cadmium exposure and cardiovascular disease. Twelve studies were identified. Overall, the pooled relative risks (95% confidence interval) for cardiovascular disease, coronary heart disease, stroke, and peripheral arterial disease were: 1.36 (95% CI: 1.11, 1.66), 1.30 (95% CI: 1.12, 1.52), 1.18 (95% CI: 0.86, 1.59), and 1.49 (95% CI: 1.15, 1.92), respectively. The pooled relative risks for cardiovascular disease in men, women and never smokers were 1.29 (1.12, 1.48), 1.20 (0.92, 1.56) and 1.27 (0.97, 1.67), respectively. Together with experimental evidence, our review supports the association between cadmium exposure and cardiovascular disease, especially for coronary heart disease. The number of studies with stroke, heart failure (HF) and peripheral arterial disease (PAD) endpoints was small. More studies, especially studies evaluating incident endpoints, are needed.
Collapse
|
48
|
Maruzeni S, Nishijo M, Nakamura K, Morikawa Y, Sakurai M, Nakashima M, Kido T, Okamoto R, Nogawa K, Suwazono Y, Nakagawa H. Mortality and causes of deaths of inhabitants with renal dysfunction induced by cadmium exposure of the polluted Jinzu River basin, Toyama, Japan; a 26-year follow-up. Environ Health 2014; 13:18. [PMID: 24629167 PMCID: PMC4234139 DOI: 10.1186/1476-069x-13-18] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 03/07/2014] [Indexed: 05/29/2023]
Abstract
BACKGROUND We aimed to investigate the mortality and causes of deaths of inhabitants with renal dysfunction induced by cadmium (Cd) exposure caused by heavy environmental contamination. METHODS We conducted a 26-year follow-up survey targeting 7529 inhabitants of the Cd-polluted Jinzu River basin and 2149 controls from non-polluted areas who participated in urinary examinations for proteinuria and glucosuria conducted in 1979 to 1984. When the residents were divided into 4 groups, no finding group, glucosuria group, proteinuria group, glucoproteinuria group, mortality risk ratios for all and specific causes of these groups in the polluted area were compared with that of controls without glucosuria and/or proteinuria after adjustments for age at baseline, smoking status, and history of hypertension using Cox's proportional hazard model. RESULTS The mortality risk ratios for all causes of proteinuria and glucoproteinuria in men and glucosuria, proteinuria, and glucoproteinuria in women of the polluted areas significantly increased compared with those of the controls with no urinary findings. Respiratory, renal, and cardiovascular diseases and diabetes in men, and all diseases except cerebrovascular diseases in women contributed toward an increased mortality of exposed glucoproteinuria groups, which involved chronic Cd toxicosis with renal tubular dysfunction. In women, the mortality risks for cancer of the colon and rectum, uterus and kidney and urinary tract were significantly higher in the exposed proteinuria and glucoproteinuria groups, suggesting associations between renal damage and cancer risk. In exposed women, the no finding group and glucoproteinuria group also showed increased mortality from ischemic heart diseases, indicating that all exposed women may be at risk for ischemic heart diseases. Although the control glucosuria and/or proteinuria group also showed high mortality for diabetes and renal diseases, the increased risk ratio for renal disease mortality was much higher in exposed subjects with urinary findings, particularly in women. CONCLUSIONS These findings indicate that inhabitants with renal effects caused by Cd exposure had a poor life prognosis over long-term observation in both genders. Particularly in women, renal tubular dysfunction indicated by glucoproteinuria may increase mortality from cancer, ischemic heart diseases, and renal diseases.
Collapse
Affiliation(s)
- Shoko Maruzeni
- Department of Public Health, Kanazawa Medical University, Uchinada 920-0293, Japan
| | - Muneko Nishijo
- Department of Public Health, Kanazawa Medical University, Uchinada 920-0293, Japan
| | - Koshi Nakamura
- Department of Public Health, Kanazawa Medical University, Uchinada 920-0293, Japan
| | - Yuko Morikawa
- School of Nursing, Kanazawa Medical University, Uchinada 920-0293, Japan
| | - Masaru Sakurai
- Department of Public Health, Kanazawa Medical University, Uchinada 920-0293, Japan
| | - Motoko Nakashima
- School of Nursing, Kanazawa Medical University, Uchinada 920-0293, Japan
| | - Teruhiko Kido
- Department of Community Health Nursing, School of Health Sciences, Kanazawa University, Kanazawa 920-0942, Japan
| | - Rie Okamoto
- Department of Community Health Nursing, School of Health Sciences, Kanazawa University, Kanazawa 920-0942, Japan
| | - Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
| | - Hideaki Nakagawa
- Department of Public Health, Kanazawa Medical University, Uchinada 920-0293, Japan
| |
Collapse
|
49
|
Abstract
BACKGROUND The toxic metal cadmium is suggested to increase the risk of cardiovascular disease, but only one incidence study has explored this association. We evaluated the association between quartiles of food frequency questionnaire-based estimates of cadmium exposure from food (the predominant source of exposure to the metal) and incident cardiovascular disease and its subtypes. METHODS From the population-based Swedish Mammography cohort, 33,333 women were followed prospectively from baseline (1997) through 2010. We estimated relative risks (RRs) with 95% confidence intervals (CIs) using Cox proportional hazard models. RESULTS During 12 years of follow-up, we identified 3155 incident cases of total cardiovascular disease (1322 cases of myocardial infarction and 1833 cases of total stroke [1485 ischemic and 208 hemorrhagic stroke]). Dietary cadmium exposure was not associated with risk of total cardiovascular disease, myocardial infarction, or total stroke or its subtypes. For total cardiovascular disease, the multivariable-adjusted RR comparing the highest quartile of cadmium exposure with the lowest was 0.96 (95% CI = 0.85-1.09). The corresponding RRs were 1.07 (0.88-1.29) for myocardial infarction, 0.90 (0.76-1.05) for total stroke, 0.89 (0.74-1.06) for ischemic stroke, and 1.11 (0.68-1.80) for hemorrhagic stroke. CONCLUSIONS Our study lends no support to an overall association between low-level exposure to cadmium via food and incident cardiovascular disease.
Collapse
|
50
|
Tellez-Plaza M, Guallar E, Fabsitz RR, Howard BV, Umans JG, Francesconi KA, Goessler W, Devereux RB, Navas-Acien A. Cadmium Exposure and Incident Peripheral Arterial Disease. Circ Cardiovasc Qual Outcomes 2013. [DOI: 10.1161/circoutcomes.112.000663] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Maria Tellez-Plaza
- From the Department of Environmental Health Sciences (M.T.-P., A.N.-A.), and Department of Epidemiology, and Welch Center for Prevention, Epidemiology, and Clinical Research (M.T.-P., E.G., A.N.-A.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Division of Epidemiology and Population Genetics, National Center for Cardiovascular Research (CNIC), Madrid, Spain (M.T.-P., E.G.); Fundacion de Investigacion del Hospital Clinico de Valencia-INCLIVA, Valencia, Spain (M.T.-P.)
| | - Eliseo Guallar
- From the Department of Environmental Health Sciences (M.T.-P., A.N.-A.), and Department of Epidemiology, and Welch Center for Prevention, Epidemiology, and Clinical Research (M.T.-P., E.G., A.N.-A.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Division of Epidemiology and Population Genetics, National Center for Cardiovascular Research (CNIC), Madrid, Spain (M.T.-P., E.G.); Fundacion de Investigacion del Hospital Clinico de Valencia-INCLIVA, Valencia, Spain (M.T.-P.)
| | - Richard R. Fabsitz
- From the Department of Environmental Health Sciences (M.T.-P., A.N.-A.), and Department of Epidemiology, and Welch Center for Prevention, Epidemiology, and Clinical Research (M.T.-P., E.G., A.N.-A.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Division of Epidemiology and Population Genetics, National Center for Cardiovascular Research (CNIC), Madrid, Spain (M.T.-P., E.G.); Fundacion de Investigacion del Hospital Clinico de Valencia-INCLIVA, Valencia, Spain (M.T.-P.)
| | - Barbara V. Howard
- From the Department of Environmental Health Sciences (M.T.-P., A.N.-A.), and Department of Epidemiology, and Welch Center for Prevention, Epidemiology, and Clinical Research (M.T.-P., E.G., A.N.-A.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Division of Epidemiology and Population Genetics, National Center for Cardiovascular Research (CNIC), Madrid, Spain (M.T.-P., E.G.); Fundacion de Investigacion del Hospital Clinico de Valencia-INCLIVA, Valencia, Spain (M.T.-P.)
| | - Jason G. Umans
- From the Department of Environmental Health Sciences (M.T.-P., A.N.-A.), and Department of Epidemiology, and Welch Center for Prevention, Epidemiology, and Clinical Research (M.T.-P., E.G., A.N.-A.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Division of Epidemiology and Population Genetics, National Center for Cardiovascular Research (CNIC), Madrid, Spain (M.T.-P., E.G.); Fundacion de Investigacion del Hospital Clinico de Valencia-INCLIVA, Valencia, Spain (M.T.-P.)
| | - Kevin A. Francesconi
- From the Department of Environmental Health Sciences (M.T.-P., A.N.-A.), and Department of Epidemiology, and Welch Center for Prevention, Epidemiology, and Clinical Research (M.T.-P., E.G., A.N.-A.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Division of Epidemiology and Population Genetics, National Center for Cardiovascular Research (CNIC), Madrid, Spain (M.T.-P., E.G.); Fundacion de Investigacion del Hospital Clinico de Valencia-INCLIVA, Valencia, Spain (M.T.-P.)
| | - Walter Goessler
- From the Department of Environmental Health Sciences (M.T.-P., A.N.-A.), and Department of Epidemiology, and Welch Center for Prevention, Epidemiology, and Clinical Research (M.T.-P., E.G., A.N.-A.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Division of Epidemiology and Population Genetics, National Center for Cardiovascular Research (CNIC), Madrid, Spain (M.T.-P., E.G.); Fundacion de Investigacion del Hospital Clinico de Valencia-INCLIVA, Valencia, Spain (M.T.-P.)
| | - Richard B. Devereux
- From the Department of Environmental Health Sciences (M.T.-P., A.N.-A.), and Department of Epidemiology, and Welch Center for Prevention, Epidemiology, and Clinical Research (M.T.-P., E.G., A.N.-A.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Division of Epidemiology and Population Genetics, National Center for Cardiovascular Research (CNIC), Madrid, Spain (M.T.-P., E.G.); Fundacion de Investigacion del Hospital Clinico de Valencia-INCLIVA, Valencia, Spain (M.T.-P.)
| | - Ana Navas-Acien
- From the Department of Environmental Health Sciences (M.T.-P., A.N.-A.), and Department of Epidemiology, and Welch Center for Prevention, Epidemiology, and Clinical Research (M.T.-P., E.G., A.N.-A.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Division of Epidemiology and Population Genetics, National Center for Cardiovascular Research (CNIC), Madrid, Spain (M.T.-P., E.G.); Fundacion de Investigacion del Hospital Clinico de Valencia-INCLIVA, Valencia, Spain (M.T.-P.)
| |
Collapse
|