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Sardar F, Kamsani YS, Ramly F, Mohamed Noor Khan NA, Sardar R, Aminuddin AA. Cadmium Associated Preeclampsia: A Systematic Literature Review of Pregnancy and Birth Outcomes. Biol Trace Elem Res 2024:10.1007/s12011-024-04364-5. [PMID: 39256331 DOI: 10.1007/s12011-024-04364-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 08/30/2024] [Indexed: 09/12/2024]
Abstract
Preeclampsia (PE), caused by multiple factors, is one of the most serious complications of pregnancy. Cadmium (Cd) is a heavy metal environmental pollutant, reproductive toxicant, and endocrine disruptor, which can increase the risk of PE. Cd toxicity due to occupational, diet, and environmental factors has worsened the risk. Studies showed elevated Cd concentration in maternal blood and placenta of PE women. However, the implicit association between Cd associated PE is still not highlighted. We systematically reviewed Cd-associated PE and its effect on pregnancy and birth outcomes. Based on "Preferred reporting items for systematic reviews and meta-analyses (PRISMA)" guidelines, eighty-six studies were identified by PubMed, Web of Science (WOS), and Scopus databases. Publications were included until October 2023 and articles screened based on our inclusion criteria. Our study identified that the exposure of controlled and uncontrolled Cd induces PE, which negatively affects pregnancy and birth outcomes. Given the serious nature of this finding, Cd is a potential adverse agent that impacts pregnancy and future neonatal health. Further comprehensive studies covering the whole trimesters of pregnancy and neonatal developments are warranted. Data on the molecular mechanisms behind Cd-induced PE is also essential for potential preventive, diagnostic, or therapeutic targets.
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Affiliation(s)
- Fatima Sardar
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
| | - Yuhaniza Shafinie Kamsani
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia.
- Maternofetal and Embryo (MatE) Research Group, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia.
| | - Fathi Ramly
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
- Department of Obstetrics & Gynaecology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
| | - Nor Ashikin Mohamed Noor Khan
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
- Maternofetal and Embryo (MatE) Research Group, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
| | - Razia Sardar
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
| | - Anisa Aishah Aminuddin
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
- Department of Obstetrics & Gynaecology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
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Huang J, El-Kersh K, Mann KK, James KA, Cai L. Overview of the cardiovascular effects of environmental metals: New preclinical and clinical insights. Toxicol Appl Pharmacol 2022; 454:116247. [PMID: 36122736 PMCID: PMC9941893 DOI: 10.1016/j.taap.2022.116247] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 02/06/2023]
Abstract
Environmental causes of cardiovascular diseases (CVDs) are global health issues. In particular, an association between metal exposure and CVDs has become evident but causal evidence still lacks. Therefore, this symposium at the Society of Toxicology 2022 annual meeting addressed epidemiological, clinical, pre-clinical animal model-derived and mechanism-based evidence by five presentations: 1) An epidemiologic study on potential CVD risks of individuals exposed occupationally and environmentally to heavy metals; 2) Both presentations of the second and third were clinical studies focusing on the potential link between heavy metals and pulmonary arterial hypertension (PAH), by presenting altered blood metal concentrations of both non-essential and essential metals in the patients with PAH and potential therapeutic approaches; 3) Arsenic-induced atherosclerosis via inflammatory cells in mouse model; 4) Pathogenic effects on the heart by adult chronic exposure to very low-dose cadmium via epigenetic mechanisms and whole life exposure to low dose cadmium via exacerbating high-fat-diet-lipotoxicity. This symposium has brought epidemiologists, therapeutic industry, physicians, and translational scientists together to discuss the health risks of occupational and environmental exposure to heavy metals through direct cardiotoxicity and indirect disruption of homeostatic mechanisms regulating essential metals, as well as lipid levels. The data summarized by the presenters infers a potential causal link between multiple metals and CVDs and defines differences and commonalities. Therefore, summary of these presentations may accelerate the development of efficient preventive and therapeutic strategies by facilitating collaborations among multidisciplinary investigators.
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Affiliation(s)
- Jiapeng Huang
- Department of Anesthesiology and Perioperative Medicine, University of Louisville School of Medicine, Louisville, KY, USA; Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY, USA; Cardiovascular Innovation Institute, Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Karim El-Kersh
- Department of Internal Medicine, Division of Pulmonary Critical Care and Sleep Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Koren K Mann
- Departments of Pharmacology & Therapeutics and Oncology and Medicine, McGill University, Canada; Segal Cancer Center, Lady Davis Institute for Medical Research, Montréal, Québec H3T 1E2, Canada
| | - Katherine A James
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA,.
| | - Lu Cai
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY, USA; Pediatric Research Institute, Departments of Pediatrics and Radiation Oncology, University of Louisville School of Medicine, Louisville, KY, USA.
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Kwon JA, Park E, Kim S, Kim B. Influence of serum ferritin combined with blood cadmium concentrations on blood pressure and hypertension: From the Korean National Health and Nutrition Examination Survey. CHEMOSPHERE 2022; 288:132469. [PMID: 34619258 DOI: 10.1016/j.chemosphere.2021.132469] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/04/2021] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Previous studies have suggested that cadmium (Cd) exposure and serum ferritin levels may influence the development of hypertension. OBJECTIVE We evaluated whether the association between blood Cd levels and the development of hypertension could be modified by serum ferritin levels in a representative sample of the adult population of South Korea. METHODS We used data from the Korean National Health and Nutrition Examination Survey (2008-2012), a nationally representative, cross-sectional, population-based study. We included 5752 adults aged 19 years and older who had records of blood Cd and ferritin levels and blood pressure measurements. Multiple logistic regression was used to examine the association between Cd exposure and the development of hypertension, as well as the modifying effects of serum ferritin. RESULTS Men had higher levels of serum ferritin, and women had higher levels of Cd. Smoking in men was significantly associated with high blood pressure and risk of hypertension. Significantly fewer women were smokers, and the combination of abnormal serum ferritin levels and high Cd levels was significantly associated with high systolic blood pressure [odds ratio (OR) = 2.11; 95% confidence interval (CI) = 1.04-4.28], high diastolic blood pressure (OR = 2.07; 95% CI = 1.04-4.12), and increased hypertension risk (OR = 1.83; 95% CI = 1.03-3.25) in women who never smoked. CONCLUSIONS Our results provide further evidence that individuals with abnormal serum ferritin levels should limit their exposure to Cd to prevent hypertension.
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Affiliation(s)
- Jeoung A Kwon
- Institute of Health Services Research, Yonsei University, 03722, Seoul, Republic of Korea.
| | - Eunjung Park
- Hanyang University Institute for Rheumatology Research, Seoul 04763, Republic of Korea
| | - Seyoung Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Byungmi Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
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Mizuno Y, Shimizu-Furusawa H, Konishi S, Inaoka T, Ahmad SA, Sekiyama M, Abdoellah OS, Gunawan B, Parajuli RP, Ikemoto Y, Lam TD, Watanabe C, Umezaki M. Associations between urinary heavy metal concentrations and blood pressure in residents of Asian countries. Environ Health Prev Med 2021; 26:101. [PMID: 34625018 PMCID: PMC8501740 DOI: 10.1186/s12199-021-01027-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/29/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Previous studies have suggested that exposures to heavy metals (arsenic, cadmium, lead, and selenium) may be associated with differences in blood pressure. However, the findings of these studies have been inconsistent. This study was performed to examine the associations between urinary heavy metal concentrations and blood pressure among residents of four Asian countries (Bangladesh, Indonesia, Nepal, and Vietnam). METHODS This cross-sectional study examined 1899 adults in four Asian countries. Urinary concentrations of heavy metals were measured by inductively coupled plasma mass spectrometry. A questionnaire survey was administered regarding individual characteristics. Anthropometric measurements (height and weight) were performed. Systolic and diastolic blood pressures were measured after a short rest. Multiple linear regression models were applied to investigate associations between urinary heavy metal concentrations and blood pressure after adjustments for age, sex, and body mass index. RESULTS The geometric means of the urinary concentrations of arsenic, cadmium, lead, and selenium were 84.6, 0.885, 2.09, and 16.5 μg/g creatinine, respectively. The urinary arsenic concentrations were slightly higher than those typically reported in non-polluted populations, while urinary cadmium, lead, and selenium concentrations were equivalent or slightly lower. The urinary lead concentrations were positively associated with both systolic and diastolic blood pressure, but urinary selenium concentrations were negatively associated with them. CONCLUSIONS Variations in the urinary concentrations of lead and selenium were associated with blood pressure at low levels of exposure/intake.
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Affiliation(s)
- Yuki Mizuno
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Hana Shimizu-Furusawa
- Department of Analytic Human Pathology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Shoko Konishi
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Tsukasa Inaoka
- Department of Human Ecology, Faculty of Agriculture, Saga University, 1 Honjo Machi, Saga, 840-0052, Japan
| | - Sk Akhtar Ahmad
- Department of Occupational and Environmental Health, Bangladesh University of Health Sciences (BUHS), Darus Salam Mirpur-1, Dhaka, 1216, Bangladesh
| | - Makiko Sekiyama
- Health and Environmental Risk Division, National Institute for Environmental Studies, Onogawa 16-2, Tsukuba, Ibaraki, 305-8506, Japan
| | - Oekan S Abdoellah
- Department of Anthropology, Faculty of Social and Political Science, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang Km. 21 Jatinangor, Sumedang, West Java Province, 45363, Indonesia
| | - Budhi Gunawan
- Department of Anthropology, Faculty of Social and Political Science, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang Km. 21 Jatinangor, Sumedang, West Java Province, 45363, Indonesia
| | - Rajendra Prasad Parajuli
- Central Department of Zoology, Central Campus, Institute of Science & Technology (IOST), Tribhuvan University, Kritipur-1, Kathmandu, Nepal
| | - Yukio Ikemoto
- Institute for Advanced Studies on Asia, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Tran Dinh Lam
- Center for Vietnamese and Southeast Asian Studies, Vietnam National University of Social Sciences and Humanities, 10-12 Dinh Tien Hoang, Ben Nghe Ward, District 1, Ho Chi Minh City, Vietnam
| | - Chiho Watanabe
- School of Tropical Medicine and Global Health, Nagasaki University (NCGM Satellite), 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Masahiro Umezaki
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Vallée A, Gabet A, Grave C, Blacher J, Olié V. Associations between urinary cadmium levels, blood pressure, and hypertension: the ESTEBAN survey. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:10748-10756. [PMID: 31950414 DOI: 10.1007/s11356-019-07249-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
Cadmium is inconsistently associated with blood pressure (BP) and hypertension. Our study focuses to understand the association between urinary cadmium levels, blood pressure, and hypertension in a French representative sample. Our study included 2015 subjects from the ESTEBAN survey (2014-2015) with measured urinary cadmium. Associations between natural logarithm-transformed cadmium levels and BP (systolic (SBP) and diastolic blood pressure (DBP)) were performed by adjusted linear regression models. Associations between cadmium and hypertension were performed by adjusted logistic regression models. Models were stratified by gender, smoking habits, body mass index (BMI), and kidney function categories. Men present higher SBP (131.7 vs. 121.5 mmHg, p < 0.0001) and DBP (78.9 vs. 74.7 mmHg, p < 0.0001) in comparison to women. Creatinine-adjusted urinary cadmium levels (0.48 vs. 0.39 μg/L, p < 0.0001) were higher in hypertensive subjects. Nevertheless, no difference was observed after adjustment for age, gender, and smoking habits. No correlation between urinary cadmium, BP, and hypertension was observed in overall population. Stratified models showed inverse correlations between urinary cadmium and hypertension among obese (OR = 0.39, 95% CI [0.21-0.57], p = 0.0009), chronic kidney function (OR = 0.68 95%CI [0.75-0.97], p = 0.003), and current smokers (OR = 0.78, 95% CI [0.64-0.92], p = 0.04). A correlation between urinary cadmium levels, BP, and hypertension is observed in subpopulations. Nevertheless, directions and significance of these associations differs by gender, BMI, smoking, and kidney function categories.
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Affiliation(s)
- Alexandre Vallée
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital, Paris Descartes University, 1 place du Parvis de Notre-Dame AP-HP, Paris, France.
| | - Amélie Gabet
- Santé Publique France, The French Public Health Agency, Saint-Maurice, France
| | - Clémence Grave
- Santé Publique France, The French Public Health Agency, Saint-Maurice, France
| | - Jacques Blacher
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital, Paris Descartes University, 1 place du Parvis de Notre-Dame AP-HP, Paris, France
| | - Valérie Olié
- Santé Publique France, The French Public Health Agency, Saint-Maurice, France
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Noor N, Zong G, Seely EW, Weisskopf M, James-Todd T. Urinary cadmium concentrations and metabolic syndrome in U.S. adults: The National Health and Nutrition Examination Survey 2001-2014. ENVIRONMENT INTERNATIONAL 2018; 121:349-356. [PMID: 30243183 PMCID: PMC6786759 DOI: 10.1016/j.envint.2018.08.029] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 08/08/2018] [Accepted: 08/11/2018] [Indexed: 05/16/2023]
Abstract
BACKGROUND Low to moderate acute cadmium exposure has been associated with increased risk of chronic diseases, such as cardiovascular and kidney disease. Little is known about the association between urinary cadmium levels-an indicator of longer-term exposure-and metabolic syndrome (MetS). METHODS We analysed data from 3982 participants aged 20-<80 years of the National Health and Nutrition Examination Survey 2001-2014. Urinary cadmium levels were measured and adjusted for creatinine using spot urine samples. Cadmium levels were evaluated in quintiles (Q). MetS was defined by National Cholesterol Education Program's Adult Treatment Panel III report criteria. Prevalence odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression accounting for complex survey design, while adjusting for potential confounders and stratifying by sex and smoking status. RESULTS In the overall study population, there was a marginal inverse association between urinary cadmium and MetS (adj. OR for Q5 versus Q1: 0.7; 95% CI: 0.5-1.0). Sex stratified models were similar. When examining individual components of MetS, participants with higher levels of urinary cadmium had decreased odds of abdominal obesity (adj. OR for Q5 versus Q1 0.4; 95% CI: 0.3-0.6), but increased odds for low HDL (adj. OR for Q5 versus Q1 2.1; 95% CI: 1.4-3.1). Among current smokers, higher urinary cadmium was associated with increased odds of MetS, hypertension, and low HDL even after accounting for serum cotinine-a marker of smoking intensity. CONCLUSIONS Higher levels of urinary cadmium, a marker of long term exposure, were not associated with an increased risk of MetS in the overall study population. However, higher urine cadmium was associated with altered MetS components. Current smokers were the most vulnerable group, with higher long-term cadmium exposure being associated with increased risk of MetS, low HDL, and hypertension.
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Affiliation(s)
- Nudrat Noor
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, United States of America
| | - Geng Zong
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, United States of America
| | - Ellen W Seely
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave., 3rd Floor, Boston, MA 02115, United States of America
| | - Marc Weisskopf
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, United States of America; Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, United States of America
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, United States of America; Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, United States of America; Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, United States of America.
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The modifying effect of kidney function on the association of cadmium exposure with blood pressure and cardiovascular mortality: NHANES 1999–2010. Toxicol Appl Pharmacol 2018; 353:15-22. [DOI: 10.1016/j.taap.2018.05.032] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/10/2018] [Accepted: 05/25/2018] [Indexed: 11/17/2022]
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Garner RE, Levallois P. Associations between cadmium levels in blood and urine, blood pressure and hypertension among Canadian adults. ENVIRONMENTAL RESEARCH 2017; 155:64-72. [PMID: 28189876 DOI: 10.1016/j.envres.2017.01.040] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/05/2017] [Accepted: 01/31/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Cadmium has been inconsistently related to blood pressure and hypertension. The present study seeks to clarify the relationship between cadmium levels found in blood and urine, blood pressure and hypertension in a large sample of adults. METHODS The study sample included participants ages 20 through 79 from multiple cycles of the Canadian Health Measures Survey (2007 through 2013) with measured blood cadmium (n=10,099) and urinary cadmium (n=6988). Linear regression models examined the association between natural logarithm transformed cadmium levels and blood pressure (separate models for systolic and diastolic blood pressure) after controlling for known covariates. Logistic regression models were used to examine the association between cadmium and hypertension. Models were run separately by sex, smoking status, and body mass index category. RESULTS Men had higher mean systolic (114.8 vs. 110.8mmHg, p<0.01) and diastolic (74.0 vs. 69.6mmHg, p<0.01) blood pressure compared to women. Although, geometric mean blood (0.46 vs. 0.38µg/L, p<0.01) and creatinine-adjusted standardized urinary cadmium levels (0.48 vs. 0.38µg/L, p<0.01) were higher among those with hypertension, these differences were no longer significant after adjustment for age, sex and smoking status. In overall regression models, increases in blood cadmium were associated with increased systolic (0.70mmHg, 95% confidence interval [CI]=0.25-1.16, p<0.01) and diastolic blood pressure (0.74mmHg, 95% CI=0.30-1.19, p<0.01). The associations between urinary cadmium, blood pressure and hypertension were not significant in overall models. Model stratification revealed significant and negative associations between urinary cadmium and hypertension among current smokers (OR=0.61, 95% CI=0.44-0.85, p<0.01), particularly female current smokers (OR=0.52, 95% CI=0.32-0.85, p=0.01). CONCLUSION This study provides evidence of a significant association between cadmium levels, blood pressure and hypertension. However, the significance and direction of this association differs by sex, smoking status, and body mass index category.
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Affiliation(s)
- Rochelle E Garner
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada.
| | - Patrick Levallois
- Direction de la santé environnementale et de la toxicologie, Institut National de Santé Publique du Québec, Québec City, Québec, Canada; Axe santé des populations et pratiques optimales en santé, Centre de Recherche du CHU de Québec-Université Laval, Québec City, Québec, Canada
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Cadmium body burden and increased blood pressure in middle-aged American Indians: the Strong Heart Study. J Hum Hypertens 2016; 31:225-230. [PMID: 27629244 PMCID: PMC5299034 DOI: 10.1038/jhh.2016.67] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/13/2016] [Accepted: 05/09/2016] [Indexed: 01/11/2023]
Abstract
Cadmium (Cd) is an environmental pollutant that has been associated with cardiovascular disease in populations, but the relationship of Cd with hypertension has been inconsistent. We studied the association between urinary Cd concentrations, a measure of total body burden, and blood pressure in American Indians, a US population with above national average Cd burden. Urinary Cd was measured using inductively coupled plasma mass spectrometry, and adjusted for urinary creatinine concentration. Among 3714 middle-aged American Indian participants of the Strong Heart Study (mean age 56 years, 41% male, 67% ever-smokers, 23% taking antihypertensive medications), urinary Cd ranged from 0.01 to 78.48 μg g-1 creatinine (geometric mean=0.94 μg g-1) and it was correlated with smoking pack-year among ever-smokers (r2=0.16, P<0.0001). Participants who were smokers were on average light-smokers (mean 10.8 pack-years), and urinary Cd was similarly elevated in light- and never-smokers (geometric means of 0.88 μg g-1 creatinine for both categories). Log-transformed urinary Cd was significantly associated with higher systolic blood pressure in models adjusted for age, sex, geographic area, body mass index, smoking (ever vs never, and cumulative pack-years) and kidney function (mean blood pressure difference by lnCd concentration (β)=1.64, P=0.002). These associations were present among light- and never-smokers (β=2.03, P=0.002, n=2627), although not significant among never-smokers (β=1.22, P=0.18, n=1260). Cd was also associated with diastolic blood pressure among light- and never-smokers (β=0.94, P=0.004). These findings suggest that there is a relationship between Cd body burden and increased blood pressure in American Indians, a population with increased cardiovascular disease risk.
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Environment-Wide Association Study of Blood Pressure in the National Health and Nutrition Examination Survey (1999-2012). Sci Rep 2016; 6:30373. [PMID: 27457472 PMCID: PMC4960597 DOI: 10.1038/srep30373] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 06/30/2016] [Indexed: 01/21/2023] Open
Abstract
Identifying environmental exposures associated with blood pressure is a priority. Recently, we proposed the environment-wide association study to search for and replicate environmental factors associated with phenotypes. We conducted the environment-wide association study (EWAS) using the National Health and Nutrition Examination Surveys (1999–2012) which evaluated a total of 71,916 participants to prioritize environmental factors associated with systolic and diastolic blood pressure. We searched for factors on participants from survey years 1999–2006 and tentatively replicated findings in participants from years 2007–2012. Finally, we estimated the overall association and performed a second meta-analysis using all survey years (1999–2012). For systolic blood pressure, self-reported alcohol consumption emerged as our top finding (a 0.04 increase in mmHg of systolic blood pressure for 1 standard deviation increase in self-reported alcohol), though the effect size is small. For diastolic blood pressure, urinary cesium was tentatively replicated; however, this factor demonstrated high heterogeneity between populations (I2 = 51%). The lack of associations across this wide of an analysis raises the call for a broader search for environmental factors in blood pressure.
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Türkcan A, Scharinger B, Grabmann G, Keppler BK, Laufer G, Bernhard D, Messner B. Combination of cadmium and high cholesterol levels as a risk factor for heart fibrosis. Toxicol Sci 2015; 145:360-71. [PMID: 25770136 DOI: 10.1093/toxsci/kfv057] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The deleterious effects of increased cadmium (Cd) serum levels on the cardiovascular system are proven by epidemiological and basic science studies. Cd exposure of animals and humans is known to impair myocardial function, possibly leading to heart failure. This study aims at investigating the effect of Cd treatment on the cardiac system with emphasis on the combined effect of Cd and high serum cholesterol levels as an important cardiovascular risk factor. Detailed analyses of Cd-induced effects on the heart of ApoE-/- mice fed a high fat diet (HFD), ApoE-/- mice fed a normal diet (ND), and C57BL/6J mice fed a ND revealed proinflammatory and fibrotic changes in the presence of cellular hypertrophy but in the absence of organ hypertrophy. Hypercholesterolemia in ApoE-/- mice alone and in combination with Cd treatment resulted in significant cardiomyocyte cell death. Based on further analyses of heart sections, we conclude that severe hypercholesterolemia in combination with ApoE-/- genotype as well as Cd treatment results in necrotic cardiomyocyte death. These data were supported by in vitro experiments showing a Cd-induced depolarization of the mitochondrial membrane and the permeabilization of the plasma membrane arguing for the occurrence of Cd-induced necrotic cell death. In summary, we were able to show for the first time that the combination of high cholesterol and Cd levels increase the risk for heart failure through cardiac fibrosis. This observation could in part be explained by the dramatically increased deposition of Cd in the hearts of ApoE-/- mice fed a HFD.
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Affiliation(s)
- Adrian Türkcan
- *Cardiac Surgery Research Laboratory, Surgical Research Laboratories, Department of Surgery, Medical University of Vienna, Vienna, Austria Institute of Inorganic Chemistry, University of Vienna, Vienna, Austria and Cardiac Surgery Research Laboratory Innsbruck, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Bernhard Scharinger
- *Cardiac Surgery Research Laboratory, Surgical Research Laboratories, Department of Surgery, Medical University of Vienna, Vienna, Austria Institute of Inorganic Chemistry, University of Vienna, Vienna, Austria and Cardiac Surgery Research Laboratory Innsbruck, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Gerlinde Grabmann
- *Cardiac Surgery Research Laboratory, Surgical Research Laboratories, Department of Surgery, Medical University of Vienna, Vienna, Austria Institute of Inorganic Chemistry, University of Vienna, Vienna, Austria and Cardiac Surgery Research Laboratory Innsbruck, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Bernhard K Keppler
- *Cardiac Surgery Research Laboratory, Surgical Research Laboratories, Department of Surgery, Medical University of Vienna, Vienna, Austria Institute of Inorganic Chemistry, University of Vienna, Vienna, Austria and Cardiac Surgery Research Laboratory Innsbruck, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Günther Laufer
- *Cardiac Surgery Research Laboratory, Surgical Research Laboratories, Department of Surgery, Medical University of Vienna, Vienna, Austria Institute of Inorganic Chemistry, University of Vienna, Vienna, Austria and Cardiac Surgery Research Laboratory Innsbruck, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - David Bernhard
- *Cardiac Surgery Research Laboratory, Surgical Research Laboratories, Department of Surgery, Medical University of Vienna, Vienna, Austria Institute of Inorganic Chemistry, University of Vienna, Vienna, Austria and Cardiac Surgery Research Laboratory Innsbruck, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Barbara Messner
- *Cardiac Surgery Research Laboratory, Surgical Research Laboratories, Department of Surgery, Medical University of Vienna, Vienna, Austria Institute of Inorganic Chemistry, University of Vienna, Vienna, Austria and Cardiac Surgery Research Laboratory Innsbruck, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
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Kukongviriyapan U, Pannangpetch P, Kukongviriyapan V, Donpunha W, Sompamit K, Surawattanawan P. Curcumin protects against cadmium-induced vascular dysfunction, hypertension and tissue cadmium accumulation in mice. Nutrients 2014; 6:1194-208. [PMID: 24662163 PMCID: PMC3967187 DOI: 10.3390/nu6031194] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 03/05/2014] [Accepted: 03/12/2014] [Indexed: 12/16/2022] Open
Abstract
Curcumin from turmeric is commonly used worldwide as a spice and has been demonstrated to possess various biological activities. This study investigated the protective effect of curcumin on a mouse model of cadmium (Cd)—induced hypertension, vascular dysfunction and oxidative stress. Male ICR mice were exposed to Cd (100 mg/L) in drinking water for eight weeks. Curcumin (50 or 100 mg/kg) was intragastrically administered in mice every other day concurrently with Cd. Cd induced hypertension and impaired vascular responses to phenylephrine, acetylcholine and sodium nitroprusside. Curcumin reduced the toxic effects of Cd and protected vascular dysfunction by increasing vascular responsiveness and normalizing the blood pressure levels. The vascular protective effect of curcumin in Cd exposed mice is associated with up-regulation of endothelial nitric oxide synthase (eNOS) protein, restoration of glutathione redox ratio and alleviation of oxidative stress as indicated by decreasing superoxide production in the aortic tissues and reducing plasma malondialdehyde, plasma protein carbonyls, and urinary nitrate/nitrite levels. Curcumin also decreased Cd accumulation in the blood and various organs of Cd-intoxicated mice. These findings suggest that curcumin, due to its antioxidant and chelating properties, is a promising protective agent against hypertension and vascular dysfunction induced by Cd.
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Affiliation(s)
- Upa Kukongviriyapan
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| | | | - Veerapol Kukongviriyapan
- Department of Pharmacology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Wanida Donpunha
- Department of Physical Therapy, Faculty of Associated Medical Science, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Kwanjit Sompamit
- Faculty of Medicine, Mahasarakham University, Mahasarakham 44000, Thailand.
| | - Praphassorn Surawattanawan
- Research and Development Institute, Government Pharmaceutical Organization, Rama 6 Road, Rajatevee, Bangkok 10400, Thailand.
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Lee BK, Kim Y. Association of blood cadmium with hypertension in the Korean general population: analysis of the 2008-2010 Korean National Health and Nutrition Examination Survey data. Am J Ind Med 2012; 55:1060-7. [PMID: 22692952 DOI: 10.1002/ajim.22078] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2012] [Indexed: 12/14/2022]
Abstract
INTRODUCTION We present data from the Korean National Health and Nutrition Examination Survey 2008-2010 regarding the association between blood cadmium levels and blood pressure in a representative sample of the adult South Korean population. METHODS We restricted the analysis to participants ≥20 years of age who completed the health examination survey, including blood cadmium measurements (n = 5,919). We performed multivariate linear regression analyses to estimate adjusted mean differences in diastolic and systolic blood pressure associated with doubling of, or quartiles of, cadmium levels after covariate adjustment. We calculated odds ratios (ORs) for hypertension and prehypertension for log-transformed blood cadmium levels and quartiles thereof after covariate adjustment. RESULTS We observed a twofold increase in blood cadmium associated with 0.755 and 1.007 mmHg increases in diastolic pressure in women and men, respectively. We observed 2.243 and 1.975 mmHg increases in diastolic pressure in women and men, respectively, in the highest compared with the lowest quartile of blood cadmium. Systolic pressure showed results similar to those of diastolic pressure. Based on ORs, a doubling of blood cadmium resulted in 18.6% and 31.5% increases in the risk of hypertension in women and men, respectively. Doubling of blood cadmium resulted in a 23.5% and 22.9% increase in the risk of prehypertension in women and men, respectively. CONCLUSION We found a significant association between blood cadmium levels and elevated blood pressure regardless of the type of variable (continuous or categorical) in women and men with a lower blood cadmium level compared to previous Korean studies. This study also showed that blood cadmium levels were robust risk factors for prehypertension in both women and men.
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Affiliation(s)
- Byung-Kook Lee
- Institute of Environmental & Occupational Medicine, Soonchunhyang University, 646 Eupnae-ri, Shinchang-myun, Asan-si, Choongnam 336-745, South Korea
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Alissa EM, Ferns GA. Heavy metal poisoning and cardiovascular disease. J Toxicol 2011; 2011:870125. [PMID: 21912545 PMCID: PMC3168898 DOI: 10.1155/2011/870125] [Citation(s) in RCA: 212] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Accepted: 06/28/2011] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular disease (CVD) is an increasing world health problem. Traditional risk factors fail to account for all deaths from CVD. It is mainly the environmental, dietary and lifestyle behavioral factors that are the control keys in the progress of this disease. The potential association between chronic heavy metal exposure, like arsenic, lead, cadmium, mercury, and CVD has been less well defined. The mechanism through which heavy metals act to increase cardiovascular risk factors may act still remains unknown, although impaired antioxidants metabolism and oxidative stress may play a role. However, the exact mechanism of CVD induced by heavy metals deserves further investigation either through animal experiments or through molecular and cellular studies. Furthermore, large-scale prospective studies with follow up on general populations using appropriate biomarkers and cardiovascular endpoints might be recommended to identify the factors that predispose to heavy metals toxicity in CVD. In this review, we will give a brief summary of heavy metals homeostasis, followed by a description of the available evidence for their link with CVD and the proposed mechanisms of action by which their toxic effects might be explained. Finally, suspected interactions between genetic, nutritional and environmental factors are discussed.
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Affiliation(s)
- Eman M. Alissa
- Faculty of Medicine, King Abdul Aziz University, P.O. Box 12713, Jeddah 21483, Saudi Arabia
| | - Gordon A. Ferns
- Institute for Science & Technology in Medicine, Faculty of Health, University of Keele, Staffordshire ST4 7QB, UK
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Boonprasert K, Ruengweerayut R, Satarug S, Na-Bangchang K. Study on the association between environmental cadmium exposure, cytochrome P450-mediated 20-HETE, heme-oxygenase-1 polymorphism and hypertension in Thai population residing in a malaria endemic areas with cadmium pollution. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2011; 31:416-426. [PMID: 21787712 DOI: 10.1016/j.etap.2011.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 02/03/2011] [Accepted: 02/06/2011] [Indexed: 05/31/2023]
Abstract
The aims of the study were to investigate (i) the effects of environmental cadmium (Cd) on hypertension, biological markers of renal dysfunction and renal cytochrome P450-mediated arachidonate metabolism; and (ii) the association between genetic polymorphism of heme oxygenase-1 (HO-1) and hypertension and Cd-induced renal injury in the exposed Thai population. The study was conducted in adult subjects residing in Cd-contaminated malaria endemic areas of Mae Sot District, Thailand. All subjects were randomly selected and consistently distributed for sex, age and residential areas. Blood and urinary Cd levels were not significantly different between the case (hypertensive) and control (matched-pair normotensive) groups. While other renal dysfunction biomarkers were comparable between the two groups, urinary microalbumin, urinary 20-hydroxy-5,8,11,14-eicosatetraenoic acid (20-HETE) and serum creatinine were siginificantly higher in the hypertensive group. Only N-acetyl-β-glucosaminidase (NAG) showed positive correlation with Cd in hypertensive and normotensive group. With respect to heme oxygenase-1 (HO-1) polymorphism, the frequencies of (GT)(n) alleles were similar in both case and control groups. The frequency of SL genotype was significantly higher in the control group, whereas the frequency of ML genotype was significantly higher in the case group. Although no significant difference between 20-HETE and NAG levels in various HO-1 genotypes was found, a trend of increase in 20-HETE and NAG levels was observed in subjects carrying longer (GT)(n) repeats. Results from the present study provide no clear evidence on the direct effects of environmental Cd on high blood pressure development in the non-occupational exposed Thai population. Furthermore, the indirect effect of Cd through HO-1 (genetic polymorphism and prevalence of long GT(n) repeats) and 20-HETE was inconclusive. Based on the data obtained in the present investigation further studies should be performed which use a larger sample size and effectively control for confounding. This should provide more definitive evidence of the relationship between Cd exposure and high blood pressure.
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Affiliation(s)
- Kanyarat Boonprasert
- Pharmacology and Toxicology Unit, Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
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Gallagher CM, Meliker JR. Blood and urine cadmium, blood pressure, and hypertension: a systematic review and meta-analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:1676-84. [PMID: 20716508 PMCID: PMC3002186 DOI: 10.1289/ehp.1002077] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Accepted: 08/17/2010] [Indexed: 05/08/2023]
Abstract
BACKGROUND Cadmium exposure has been inconsistently related to blood pressure. OBJECTIVES We updated and reevaluated the evidence regarding the relationships of blood cadmium (BCd) and urine cadmium (UCd) with blood pressure (BP) and hypertension (HTN) in nonoccupationally exposed populations. DATA SOURCES AND EXTRACTION We searched PubMed and Web of Science for articles on BCd or UCd and BP or HTN in nonoccupationally exposed populations and extracted information from studies that provided sufficient data on population, smoking status, exposure, outcomes, and design. DATA SYNTHESIS Twelve articles met inclusion criteria: eight provided data adequate for comparison, and five reported enough data for meta-analysis. Individual studies reported significant positive associations between BCd and systolic BP (SBP) among nonsmoking women [ß = 3.14 mmHg per 1 μg/L untransformed BCd; 95% confidence interval (CI), 0.14-6.14] and among premenopausal women (ß = 4.83 mmHg per 1 nmol/L log-transformed BCd; 95% CI, 0.17-9.49), and between BCd and diastolic BP (DBP) among women (ß = 1.78 mmHg comparing BCd in the 90th and 10th percentiles; 95% CI, 0.64-2.92) and among premenopausal women (ß = 3.84 mmHg per 1 nmol/L log-transformed BCd; 95% CI, 0.86-6.82). Three meta-analyses, each of three studies, showed positive associations between BCd and SBP (p = 0.006) and DBP (p < 0.001) among women, with minimal heterogeneity (I² = 3%), and a significant inverse association between UCd and HTN among men and women, with substantial heterogeneity (I² = 80%). CONCLUSION Our results suggest a positive association between BCd and BP among women; the results, however, are inconclusive because of the limited number of representative population-based studies of never-smokers. Associations between UCd and HTN suggest inverse relationships, but inconsistent outcome definitions limit interpretation. We believe a longitudinal study is merited.
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Affiliation(s)
- Carolyn M Gallagher
- Doctoral Program in Population Health and Clinical Outcomes Research, Stony Brook University Medical Center, Stony Brook, New York, USA.
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Gallagher CM, Chen JJ, Kovach JS. Environmental cadmium and breast cancer risk. Aging (Albany NY) 2010; 2:804-14. [PMID: 21071816 PMCID: PMC3006023 DOI: 10.18632/aging.100226] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 11/08/2010] [Indexed: 12/02/2022]
Abstract
Breast cancer is the most prevalent women's cancer, with an age-adjusted incidence of 122.9 per 100,000 US women. Cadmium, a ubiquitous carcinogenic pollutant with multiple biological effects, has been reported to be associated with breast cancer in one US regional case-control study. We examined the association of breast cancer with urinary cadmium (UCd), in a case-control sample of women living on Long Island (LI), NY (100 with breast cancer and 98 without), a region with an especially high rate of breast cancer (142.7 per 100,000 in Suffolk County) and in a representative sample of US women (NHANES 1999-2008, 92 with breast cancer and 2,884 without). In a multivariable logistic model, both samples showed a significant trend for increased odds of breast cancer across increasing UCd quartiles (NHANES, p=0.039 and LI, p=0.023). Compared to those in the lowest quartile, LI women in the highest quartile had increased risk for breast cancer (OR=2.69; 95% CI=1.07, 6.78) and US women in the two highest quartiles had increased risk (OR=2.50; 95% CI=1.11, 5.63 and OR=2.22; 95% CI=.89, 5.52, respectively). Further research is warranted on the impact of environmental cadmium on breast cancer risk in specific populations and on identifying the underlying molecular mechanisms.
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Affiliation(s)
- Carolyn M. Gallagher
- Doctoral Program in Population Health and Clinical Outcomes Research, Stony Brook University, Stony Brook, NY 11794, USA
- Department of Preventive Medicine, Stony Brook University, New York, Department of Preventive Medicine, Z=8036, Level 3, HSC, Stony Brook University, Stony Brook, NY 11794, USA
| | - John J. Chen
- Department of Preventive Medicine, Stony Brook University, New York, Department of Preventive Medicine, Z=8036, Level 3, HSC, Stony Brook University, Stony Brook, NY 11794, USA
| | - John S. Kovach
- Department of Preventive Medicine, Stony Brook University, New York, Department of Preventive Medicine, Z=8036, Level 3, HSC, Stony Brook University, Stony Brook, NY 11794, USA
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Swaddiwudhipong W, Mahasakpan P, Limpatanachote P, Krintratun S. Correlations of urinary cadmium with hypertension and diabetes in persons living in cadmium-contaminated villages in northwestern Thailand: A population study. ENVIRONMENTAL RESEARCH 2010; 110:612-6. [PMID: 20561611 DOI: 10.1016/j.envres.2010.06.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Revised: 05/31/2010] [Accepted: 06/04/2010] [Indexed: 05/22/2023]
Abstract
Risk for hypertension and diabetes has not been conclusively found to be a result of cadmium exposure. A population-based study was conducted in 2009 to examine the correlations of urinary cadmium, a good biomarker of long-term cadmium exposure, with hypertension and diabetes in persons aged 35 years and older who lived in the 12 cadmium-contaminated rural villages in northwestern Thailand. A total of 5273 persons were interviewed and screened for urinary cadmium, hypertension, and diabetes. The geometric mean level of urinary cadmium for women (2.4+/-2.3 microg/g creatinine) was significantly greater than that for men (2.0+/-2.2 microg/g creatinine). Hypertension was presented in 29.8% of the study population and diabetes was detected in 6.6%. The prevalence of hypertension significantly increased from 25.0% among persons in the lowest tertile of urinary cadmium to 35.0% in the highest tertile. In women, the rate of hypertension significantly increased with increasing urinary cadmium levels in both ever and never smokers, after adjusting for age, alcohol consumption, body mass index, and diabetes. In men, such association was less significantly found in never smokers. The study revealed no significant association between urinary cadmium and diabetes in either gender. Our study supports the hypothesis that environmental exposure to cadmium may increase the risk of hypertension. Risk for diabetes in relation to cadmium exposure remains uncertain in this exposed population.
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Affiliation(s)
- Witaya Swaddiwudhipong
- Department of Community and Social Medicine, Mae Sot General Hospital, Tak 63110, Thailand.
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Apinan R, Satarug S, Ruengweerayut R, Mahavorasirikul W, Na-Bangchang K. The influence of iron stores on cadmium body burden in a Thai population. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2010; 32:237-242. [PMID: 19806462 DOI: 10.1007/s10653-009-9280-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Accepted: 09/18/2009] [Indexed: 05/28/2023]
Abstract
Cadmium is a toxin of increasing public health concern due to its presence in most human foodstuffs and in cigarette smoke. Exposure to cadmium leads to tissue bioaccumulation and, in particular, has nephrotoxic effects. The aim of the present study was to investigate the association between cadmium body burden and iron stores in a Thai population. A total of 182 healthy adult Thai subjects of both genders (89 males, 93 females) aged between 18 and 57 years and weighing 40-95 kg were included in this study. The total amounts of cadmium excreted in urine over 2 h (microg/g creatinine) were used as an index of long-term cadmium exposure. Quantitation of cadmium was performed using electrothermal (graphite furnace) atomic absorption spectrometry. The urinary cadmium excreted displayed a normal frequency distribution. The average urinary cadmium level did not exceed the WHO maximum tolerable internal dose for the non-exposed population (2 microg/g creatinine). Body iron stores reflected by serum ferritin levels did not show any correlation with cadmium burden in both males and females, although a relatively stronger influence of body iron store status on cadmium burden was shown in females. When the levels of serum ferritin were stratified into five levels (<20, 20-100, 101-200, 201-300, and >300 microg/l), a significant difference in total cadmium body burden was observed between females and males only in the group with a low level of serum ferritin of <20 microg/l. The cadmium body burden in females was about twice that in males in this group.
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Gallagher CM, Moonga BS, Kovach JS. Cadmium, follicle-stimulating hormone, and effects on bone in women age 42-60 years, NHANES III. ENVIRONMENTAL RESEARCH 2010; 110:105-111. [PMID: 19875111 DOI: 10.1016/j.envres.2009.09.012] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Revised: 09/17/2009] [Accepted: 09/30/2009] [Indexed: 05/28/2023]
Abstract
BACKGROUND Increased body burden of environmental cadmium has been associated with greater risk of decreased bone mineral density (BMD) and osteoporosis in middle-aged and older women, and an inverse relationship has been reported between follicle-stimulating hormone (FSH) and BMD in middle-aged women; however, the relationships between cadmium and FSH are uncertain, and the associations of each with bone loss have not been analyzed in a single population. OBJECTIVES The objective of this study was to evaluate the associations between creatinine-adjusted urinary cadmium (UCd) and FSH levels, and the associations between UCd and FSH with BMD and osteoporosis, in postmenopausal and perimenopausal women aged 42-60 years. METHODS Data were obtained from the Third National Health Examination and Nutrition Survey, 1988-1994 (NHANES III). Outcomes evaluated were serum FSH levels, femoral bone mineral density measured by dual energy X-ray absorptiometry, and osteoporosis indicated by femoral BMD cutoffs based on the international standard. Urinary cadmium levels were analyzed for association with these outcomes, and FSH levels analyzed for association with bone effects, using multiple regression. Subset analysis was conducted by a dichotomous measure of body mass index (BMI) to proxy higher and lower adipose-synthesized estrogen effects. RESULTS UCd was associated with increased serum FSH in perimenopausal women with high BMI (n=642; beta=0.45; p< or =0.05; R(2)=0.35) and low BMI (n=408; beta=0.61; p< or =0.01; R(2)=0.34). Among perimenopausal women with high BMI, BMD was inversely related to UCd (beta=-0.04; p< or =0.05) and FSH (beta=-0.03; p< or =0.05). In postmenopausal women with low BMI, an incremental increase in FSH was associated with 2.78 greater odds for osteoporosis (109 with and 706 without) (OR=2.78; 95% CI=1.43, 5.42; p< or =0.01). CONCLUSION Long-term cadmium exposure at environmental levels is associated with increased serum FSH, and both FSH and UCd are associated with bone loss, in US women aged 42-60 years.
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Affiliation(s)
- Carolyn M Gallagher
- PhD Program in Population Health and Clinical Outcomes Research, Stony Brook University, Health Sciences Center L3-R071, Stony Brook, New York 11794-8338, USA.
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Cao Y, Chen A, Radcliffe J, Dietrich KN, Jones RL, Caldwell K, Rogan WJ. Postnatal cadmium exposure, neurodevelopment, and blood pressure in children at 2, 5, and 7 years of age. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:1580-6. [PMID: 20019909 PMCID: PMC2790513 DOI: 10.1289/ehp.0900765] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 05/26/2009] [Indexed: 05/18/2023]
Abstract
BACKGROUND Adverse health effects of cadmium in adults are well documented, but little is known about the neuropsychological effects of cadmium in children, and no studies of cadmium and blood pressure in children have been conducted. OBJECTIVE We examined the potential effects of low-level cadmium exposure on intelligence quotient, neuropsychological functions, behavior, and blood pressure among children, using blood cadmium as a measure of exposure. METHODS We used the data from a multicenter randomized clinical trial of lead-exposed children and analyzed blood cadmium concentrations using the whole blood samples collected when children were 2 years of age. We compared neuropsychological and behavioral scores at 2, 5, and 7 years of age by cadmium level and analyzed the relationship between blood cadmium levels at 2 years of age and systolic and diastolic blood pressure at 2, 5, and 7 years of age. RESULTS The average cadmium concentration of these children was 0.21 microg/L, lower than for adults in the National Health and Nutrition Examination Survey (NHANES), but comparable to concentrations in children < 3 years of age in NHANES. Except for the California Verbal Learning Test for Children, there were no differences in test scores among children in different cadmium categories. For children with detectable pretreatment blood cadmium, after adjusting for a variety of covariates, general linear model analyses showed that at none of the three age points was the coefficient of cadmium on Mental Development Index or IQ statistically significant. Spline regression analysis suggested that behavioral problem scores at 5 and 7 years of age tended to increase with increasing blood cadmium, but the trend was not significant. We found no significant associations between blood cadmium levels and blood pressure. CONCLUSION We found no significant associations between background blood cadmium levels at 2 years of age and neurodevelopmental end points and blood pressure at 2, 5, and 7 years of age. The neuropsychological or hypertensive effects from longer background exposures to cadmium need further study.
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Affiliation(s)
- Yang Cao
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
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Gallagher CM, Kovach JS, Meliker JR. Urinary cadmium and osteoporosis in U.S. Women >or= 50 years of age: NHANES 1988-1994 and 1999-2004. ENVIRONMENTAL HEALTH PERSPECTIVES 2008; 116:1338-43. [PMID: 18941575 PMCID: PMC2569092 DOI: 10.1289/ehp.11452] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2008] [Accepted: 06/12/2008] [Indexed: 05/03/2023]
Abstract
BACKGROUND Urinary cadmium (U-Cd) has been associated with decreased peripheral bone mineral density (BMD) and osteoporosis. This association, however, has not been confirmed using femoral BMD, the international standard for diagnosing osteoporosis, at levels < 1.0 microg Cd/g creatinine. OBJECTIVES Our goal was to investigate the statistical association between U-Cd, at levels or= 50 years of age. METHODS We drew data from the National Health and Nutrition Examination Surveys for 1988-1994 (n = 3,207) and 1999-2004 (n = 1,051). Osteoporosis was indicated by hip BMD cutoffs based on the international standard and self-report of physician diagnosis. We analyzed U-Cd levels for association with osteoporosis using multiple logistic regression. RESULTS Women >or= 50 years of age with U-Cd levels between 0.50 and 1.00 microg/g creatinine were at 43% greater risk for hip-BMD-defined osteoporosis, relative to those with levels CONCLUSIONS Results suggest that U.S. women are at risk for osteoporosis at U-Cd levels below the U.S. Occupational Safety and Health Administration's 3-microg/g safety standard. Given null findings among smokers, dietary Cd, rather than tobacco, is the likely source of Cd-related osteoporosis risk for the U.S. female population >or= 50 years of age.
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Affiliation(s)
- Carolyn M Gallagher
- Graduate Program in Public Health, Stony Brook University Medical Center, Stony Brook, New York 11790, USA.
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Tellez-Plaza M, Navas-Acien A, Crainiceanu CM, Guallar E. Cadmium exposure and hypertension in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). ENVIRONMENTAL HEALTH PERSPECTIVES 2008; 116:51-6. [PMID: 18197299 PMCID: PMC2199293 DOI: 10.1289/ehp.10764] [Citation(s) in RCA: 216] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2007] [Accepted: 10/30/2007] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Cadmium induces hypertension in animal models. Epidemiologic studies of cadmium exposure and hypertension, however, have been inconsistent. OBJECTIVE We aimed to investigate the association of blood and urine cadmium with blood pressure levels and with the prevalence of hypertension in U.S. adults who participated in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). METHODS We studied participants > or = 20 years of age with determinations of cadmium in blood (n = 10,991) and urine (n = 3,496). Blood and urine cadmium were measured by atomic absorption spectrometry and inductively coupled plasma-mass spectrometry, respectively. Systolic and diastolic blood pressure levels were measured using a standardized protocol. RESULTS The geometric means of blood and urine cadmium were 3.77 nmol/L and 2.46 nmol/L, respectively. After multivariable adjustment, the average differences in systolic and diastolic blood pressure comparing participants in the 90th vs. 10th percentile of the blood cadmium distribution were 1.36 mmHg [95% confidence interval (CI), -0.28 to 3.00] and 1.68 mmHg (95% CI, 0.57-2.78), respectively. The corresponding differences were 2.35 mmHg and 3.27 mmHg among never smokers, 1.69 mmHg and 1.55 mmHg among former smokers, and 0.02 mmHg and 0.69 mmHg among current smokers. No association was observed for urine cadmium with blood pressure levels, or for blood and urine cadmium with the prevalence of hypertension. CONCLUSIONS Cadmium levels in blood, but not in urine, were associated with a modest elevation in blood pressure levels. The association was stronger among never smokers, intermediate among former smokers, and small or null among current smokers. Our findings add to the concern of renal and cardiovascular cadmium toxicity at chronic low levels of exposure in the general population.
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Affiliation(s)
- Maria Tellez-Plaza
- Department of Environmental Health Sciences and
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Cardiovascular Epidemiology and Population Genetics, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences and
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Address correspondence to A. Navas-Acien, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Rm. W7033B, Baltimore, Maryland 21205 USA. Telephone: (410) 502-4267. Fax: (410) 955-1811. E-mail:
| | - Ciprian M. Crainiceanu
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Cardiovascular Epidemiology and Population Genetics, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
- Departments of Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
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Bernhard D, Rossmann A, Henderson B, Kind M, Seubert A, Wick G. Increased serum cadmium and strontium levels in young smokers: effects on arterial endothelial cell gene transcription. Arterioscler Thromb Vasc Biol 2006; 26:833-8. [PMID: 16439709 DOI: 10.1161/01.atv.0000205616.70614.e5] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Metal constituents of tobacco have long been suspected to contribute to cardiovascular diseases. In this study, we determined the serum concentrations of aluminum, cadmium (Cd), cobalt, copper, iron, manganese, nickel, lead, strontium (Sr), and zinc of young nonsmokers, passive smokers, and smokers. METHODS AND RESULTS Cd and Sr were found to be significantly increased in smokers compared with nonsmokers. The effects of these metals on primary arterial endothelial cells were then assessed using microarray technology and real-time polymerase chain reaction (RT-PCR). The data showed that Sr does not interfere with endothelial cell transcription. In contrast, the effects of Cd in amounts delivered to the human body by smoking were dramatic. CONCLUSIONS Arterial endothelial cells responded to Cd exposure by massively upregulating metal and oxidant defense genes (metallothioneins) and by downregulating a number of transcription factors. In addition, the mRNA of the intermediate filament protein vimentin, crucial for the maintenance of cellular shape, was reduced. Surprisingly, a number of pro-inflammatory genes were downregulated in response to Cd. The present data suggest that by delivering Cd to the human body, smoking deregulates transcription, exerts stress, and damages the structure of the vascular endothelium; furthermore, in contrast to the effects of cigarette smoke as a whole, Cd seems to possess anti-inflammatory properties.
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Affiliation(s)
- David Bernhard
- Vascular Biology Group, Division Experimental Pathophysiology and Immunology, Biocenter, Innsbruck Medical University, Innsbruck, Austria.
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Cui Y, Zhu YG, Zhai R, Huang Y, Qiu Y, Liang J. Exposure to metal mixtures and human health impacts in a contaminated area in Nanning, China. ENVIRONMENT INTERNATIONAL 2005; 31:784-90. [PMID: 15979144 DOI: 10.1016/j.envint.2005.05.025] [Citation(s) in RCA: 145] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Cadmium and lead have been identified as very toxic metals, which are widely present in the environment due to natural and anthropogenic emissions. Many studies have shown that the food chain is the main pathway of cadmium and lead transfer from the environment to humans. It is well documented that many factors will affect their transfer through food chains. Previous investigations on heavy metals were mostly concentrated on one contaminant in isolation. However, in real environments, exposure to mixtures of metals is ubiquitous such that cadmium pollution is invariably being associated with lead and zinc, etc. This study focuses on the contamination and health effects of the metal mixtures. For this purpose, a dietary survey was taken for 3 groups in Nanning in October 2002. Samples of soils, plants (vegetables), urine and blood of humans were measured for Cd, Fe, Cu, Zn, Ca and Pb, in addition, the urinary indicators of renal dysfunction Albumin (ALB), N-acetyl-beta-D-glucosaminidase (NAG), Beta-2-microglobulin (beta2-MG) and Retinol-binding protein (RBP) in urine were also measured. Results showed that soil contamination with metal mixtures had caused significant renal dysfunction of the local residents living in the contaminated area, and the dose-response curve was somewhat altered by the mixed contamination of Cd and Pb as well as the intake of other minerals. The importance of mixtures of metal contamination and human health are also discussed in this paper.
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Affiliation(s)
- Yujing Cui
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, 100085, Beijing, China
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26
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Telisman S, Pizent A, Jurasović J, Cvitković P. Lead effect on blood pressure in moderately lead-exposed male workers. Am J Ind Med 2004; 45:446-54. [PMID: 15095427 DOI: 10.1002/ajim.20006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The effect of lead (Pb) and potential confounding variables on blood pressure was examined in healthy male industrial workers 20-43 years of age. METHODS In 100 Pb workers and 51 reference subjects, the following variables were measured: blood Pb (BPb), activity of delta-aminolevulinic acid dehydratase (ALAD), erythrocyte protoporphyrin (EP), blood cadmium (BCd), serum zinc (SZn), serum copper (SCu), hematocrit (Hct), body mass index (BMI), and blood pressure. The inter-relationship of biomarkers of Pb (BPb, ALAD, EP) and BCd, SZn, SCu, Hct, BMI, age, smoking, and alcohol to systolic and diastolic blood pressure was calculated by forward stepwise multiple regression. RESULTS There was no significant difference in blood pressure between the two groups, possibly because the reference subjects had relatively high BPb levels and significantly higher BMI (P < 0.05) as compared to the Pb workers. According to the multiple regression results in Pb workers, an increase in systolic blood pressure was significantly associated with increasing EP (P = 0.001) and BMI (P < 0.002), or alternatively with increasing BMI (P < 0.004) and decreasing ALAD (P < 0.04) and BCd (P < 0.05). An increase in diastolic blood pressure was significantly associated with increasing BMI (P < 0.009) and EP (P = 0.05) and decreasing BCd (P < 0.04). With respect to the EP range of 0.73-13.94 micromol/l erythrocytes in 100 Pb workers, an increase of 17 mm Hg in systolic and 6 mm Hg in diastolic blood pressure was found. CONCLUSIONS Long-term cumulative Pb exposure, which is better reflected by EP than by ALAD or current BPb level, can significantly increase blood pressure in moderately Pb-exposed male workers (long-term average BPb <400 microg/l; exposure duration 2-21 years).
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Affiliation(s)
- Spomenka Telisman
- Department of Occupational and Environmental Health, Institute for Medical Research and Occupational Health, Zagreb, Croatia.
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Akesson A, Berglund M, Schütz A, Bjellerup P, Bremme K, Vahter M. Cadmium exposure in pregnancy and lactation in relation to iron status. Am J Public Health 2002; 92:284-7. [PMID: 11818307 PMCID: PMC1447058 DOI: 10.2105/ajph.92.2.284] [Citation(s) in RCA: 175] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the impact of iron status on cadmium dose among pregnant women. METHODS Iron status and cadmium concentration in blood, urine, and placenta were determined among women followed for 2 years from early pregnancy. RESULTS Blood cadmium and urinary cadmium were correlated with iron status throughout the study period. Urinary cadmium increased longitudinally among women with exhausted iron stores during their pregnancy. The increase in urinary cadmium with age was more pronounced in multiparous than in nulliparous women. CONCLUSIONS Iron deficiency during pregnancy leads to increased cadmium absorption and body burden. Multiparous women exhibit additional increases with increasing age.
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Affiliation(s)
- Agneta Akesson
- Institute of Environmental Medicine, Division of Metals and Health, Karolinska Institutet, Stockholm, Sweden.
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Telisman S, Jurasović J, Pizent A, Cvitković P. Blood pressure in relation to biomarkers of lead, cadmium, copper, zinc, and selenium in men without occupational exposure to metals. ENVIRONMENTAL RESEARCH 2001; 87:57-68. [PMID: 11683589 DOI: 10.1006/enrs.2001.4292] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The interrelationship of blood lead (BPb), activity of delta-aminolevulinic acid dehydratase (ALAD), erythrocyte protoporphyrin (EP), blood cadmium (BCd), serum copper (SCu), serum zinc (SZn), serum selenium (SSe), hematocrit (Hct), body mass index (BMI), age, smoking habits, and alcohol consumption to blood pressure was examined in 154 Croatian male subjects 19-53 years of age. None of the subjects had been occupationally exposed to metals, or used any medication that could influence blood pressure or metal metabolism. The median and range values were: BPb, 57 (25-254) microg/L; ALAD, 51.9 (22.8-96.4) European units; EP, 0.68 (0.38-1.68) micromol/L erythrocytes; BCd, 0.83 (0.21-11.93) microg/L; SCu, 1113 (763-1662) microg/L; SZn, 961 (734-1213) microg/L; SSe, 73.6 (44.2-106.9) microg/L; systolic blood pressure, 131 (105-165) mm Hg; and diastolic blood pressure, 94 (71-112) mm Hg. Systolic and diastolic blood pressure significantly correlated with an increase in BMI (P<0.0005 and P<0.0001, respectively), EP (P<0.0002 and P<0.002, respectively), and BPb (P<0.005 and P<0.01, respectively). After adjusting for potential confounding variables by multiple regression, an increase in systolic blood pressure was significantly predictive by BMI (P<0.0005) and log BPb (P<0.02) and inversely by log BPb*SSe interaction term (P<0.007), or alternatively by EP (P<0.0001), BMI (P<0.001), alcohol (P<0.02), and Hct (P<0.05). An increase in diastolic blood pressure was significantly predictive by BMI (P<10(-5)), log BPb (P<0.04), and alcohol (P=0.05) and inversely by log BPb*SSe interaction term (P<0.0007), or alternatively by BMI (P<0.0001), EP (P<0.002), alcohol (P<0.004), and Hct (P<0.04) and inversely by smoking (P<0.04). With respect to the EP range in the study population, an increase of 27 mm Hg in systolic and 14 mm Hg in diastolic blood pressure was found. The study results indicate a significant Pb-related increase in blood pressure, particularly within the low-level Pb exposure range (BPb of 25-75 microg/L, and/or EP of 0.4-1.0 micromol/L erythrocytes).
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Affiliation(s)
- S Telisman
- Institute for Medical Research and Occupational Health, Zagreb, Croatia.
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Pizent A, Jurasovie J, Telisman S. Blood pressure in relation to dietary calcium intake, alcohol consumption, blood lead, and blood cadmium in female nonsmokers. J Trace Elem Med Biol 2001; 15:123-30. [PMID: 11787977 DOI: 10.1016/s0946-672x(01)80055-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The interrelationship of dietary calcium (Ca) intake, alcohol consumption, blood lead (BPb), blood cadmium (BCd), age, and body mass index (BMI) to blood pressure was examined in 267 peasant women 40-85 years of age. They were residents of two rural areas in Croatia and differed with regard to dietary Ca intake: 100 women with low Ca intake (approximately 450 mg/day) and 167 women with relatively high Ca intake (approximately 940 mg/day). All of the women were nonsmokers and consumed very little or no alcohol. Median and range BPb values were 74 (29-251) microg/L in women with low Ca intake and 59 (21-263) microg/L in women with high Ca intake (p < 0.0002), whereas corresponding BCd values were 0.6 (0.2-3.6) microg/L and 0.6 (0.3-4.5) microg/L (p > 0.10). Results of multiple regression showed a significant (p < 0.05) increase in systolic blood pressure with age, BMI, and BCd, and marginally with alcohol consumption (multiple r = 0.48, p < 10(- 6)). An increase in diastolic blood pressure was significantly (p < 0.05) associated with BMI, age, and residence area (i.e., it was higher in women with low Ca intake), and marginally with BCd, and alcohol consumption (multiple r = 0.38, p < 10(-6)) When the two groups of women with different Ca intake were subdivided into consumers and nonconsumers of alcohol, BPb was related positively to alcohol consumption and inversely to Ca intake. The highest BPb was found in the subgroup of alcohol consumers with low Ca intake, and the lowest BPb in the subgroup of nonconsumers with high Ca intake: 78 (42-251) microg/L and 51 (22-192) microg/L, respectively (p < 10(-8)). Diastolic blood pressure was significantly higher in the former subgroup as compared to the latter: 95 (72-130) mm Hg and 90 (60-120) mm Hg, respectively (p < 0.05). This cannot be explained by age, BMI, or BCd, which were comparable in the two subgroups. The results indicate that alcohol consumption and low Ca intake can increase BPb, which may significantly contribute to an increase in diastolic blood pressure in female nonsmokers even at relatively low-level Pb exposure.
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Affiliation(s)
- A Pizent
- Department of Occupational and Environmental Health, Institute for Medical Research and Occupational Health, Zagreb, Croatia
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Staessen JA, O'Brien ET, Thijs L, Fagard RH. Modern approaches to blood pressure measurement. Occup Environ Med 2000; 57:510-20. [PMID: 10896957 PMCID: PMC1740006 DOI: 10.1136/oem.57.8.510] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Blood pressure (BP) is usually measured by conventional sphygmomanometry. Although apparently simple, this procedure is fraught with many potential sources of error. This review focuses on two alternative techniques of BP measurement: ambulatory monitoring and self measurement. REVIEW BP values obtained by ambulatory monitoring or self measurement are characterised by high reproducibility, are not subject to digit preference or observer bias, and minimise the transient rise of the blood pressure in response to the surroundings of the clinic or the presence of the observer, the so called white coat effect. For ambulatory monitoring, the upper limits of systolic/diastolic normotension in adults include 130/80 mm Hg for the 24 hour BP and 135/85 and 120/70 mm Hg for the daytime BP and night time BP, respectively. For the the self measured BP these thresholds include 135/85 mm Hg. Automated BP measurement is most useful to identify patients with white coat hypertension. Whether or not white coat hypertension predisposes to sustained hypertension remains debated. However, outcome is better correlated with the ambulatory BP than with the conventional BP. In patients with white coat hypertension, antihypertensive drugs lower the BP in the clinic, but not the ambulatory BP, and also do not improve prognosis. Ambulatory BP monitoring is also better than conventional BP measurement in assessing the effects of treatment. Ambulatory BP monitoring is necessary to diagnose nocturnal hypertension and is especially indicated in patients with borderline hypertension, elderly patients, pregnant women, patients with treatment resistant hypertension, and also in patients with symptoms suggestive of hypotension. CONCLUSIONS The newer techniques of BP measurement are now well established in clinical research, for diagnosis in clinical practice, and will increasingly make their appearance in occupational and environmental medicine.
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Affiliation(s)
- J A Staessen
- Studiecoördinatie-centrum, Laboratorium Hypertensie, Campus Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.
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Staessen JA, Kuznetsova T, Roels HA, Emelianov D, Fagard R. Exposure to cadmium and conventional and ambulatory blood pressures in a prospective population study. Public Health and Environmental Exposure to Cadmium Study Group. Am J Hypertens 2000; 13:146-56. [PMID: 10701814 DOI: 10.1016/s0895-7061(99)00187-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
This prospective population study investigated in a random sample of 692 subjects (age 20-83 years) how changing environmental exposure to cadmium influenced blood pressure (BP) and the incidence of hypertension. At baseline (1985 to 1989; participation rate, 78%) and follow-up (1991 to 1995; re-examination rate, 81%), blood pressure was measured by conventional sphygmomanometry (CBP; 15 readings in total) and, at follow-up, also by 24-h ambulatory blood pressure monitoring (ABP). Systolic/diastolic CBP at baseline averaged 128.4/77.3 mm Hg. At baseline, blood cadmium concentration (B-Cd) and urinary cadmium excretion (U-Cd) averaged (geometric means) 11.1 nmol/L and 10.2 nmol/24 h. Over 5.2 years (median follow-up), B-Cd fell by 29.6% and U-Cd by 15.2%. B-Cd fell less in subjects living closer to three zinc smelters and in premenopausal women. During follow-up, systolic CBP decreased by 2.2 mm Hg in men and remained unchanged in women, and diastolic CBP increased by 1.8 mm Hg in both sexes. No relationship could be demonstrated between the secular trends in CBP and B-Cd or U-Cd or between B-Cd or U-Cd at baseline and the incidence of hypertension. In addition, in cross-sectional analyses involving the average of all available CBP measurements in each participant or 24-h ABP at follow-up (mean, 119.1/71.4 mm Hg), blood pressure was not correlated with B-Cd or U-Cd. In conclusion, environmental exposure to cadmium was not associated with higher CBP or 24-h ABP or with increased risk for hypertension. The lesser fall in B-Cd in the residents living closer to the zinc smelters or in premenopausal women underscores the necessity to sanitize cadmium-polluted areas and to systematically reinforce the preventive measures to be adopted by exposed communities to reduce cadmium uptake.
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Affiliation(s)
- J A Staessen
- Hypertensie en Cardiovasculaire Revalidatie Eenheid, Departement voor Cardiovasculair en Moleculair Onderzoek, Katholieke Universiteit Leuven, Belgium.
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32
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Blood Cadmium Levels in Nonexposed Male Subjects Living in the Rome Area: Relationship to Selected Cardiovascular Risk Factors. Microchem J 1998. [DOI: 10.1006/mchj.1998.1598] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Demontis MP, Varoni MV, Volpe AR, Emanueli C, Madeddu P. Role of nitric oxide synthase inhibition in the acute hypertensive response to intracerebroventricular cadmium. Br J Pharmacol 1998; 123:129-35. [PMID: 9484863 PMCID: PMC1565133 DOI: 10.1038/sj.bjp.0701573] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
1. In the rat, intracerebroventricular (i.c.v.) injection of cadmium, a pollutant with long biological half-life, causes a sustained increase in blood pressure at doses that are ineffective by peripheral route. Since cadmium inhibits calcium-calmodulin constitutive nitric oxide (NO) synthase in cytosolic preparations of rat brain, this mechanism may be responsible for the acute pressor action of this heavy metal. 2. To test this possibility, we evaluated the effect of i.c.v. injection of 88 nmol cadmium in normotensive unanaesthetized Wistar rats, which were i.c.v. pre-treated with: (1) saline (control), (2) L-arginine (L-Arg), to increase the availability of substrate for NO biosynthesis, (3) D-arginine (D-Arg), (4) 3-[4-morpholinyl]-sydnonimine-hydrochloride (SIN-1), an NO donor, or (5) CaCl2, a cofactor of brain calcium-calmodulin-dependent cNOS(I). In additional experiments, the levels of L-citrulline (the stable equimolar product derived from enzymatic cleavage of L-Arg by NO synthase) were determined in the brain of vehicle- or cadmium-treated rats. 3. The pressor response to cadmium reached its nadir at 5 min (43+/-4 mmHg) and lasted over 20 min in controls. L-Citrulline/protein content was reduced from 35 up to 50% in the cerebral cortex, pons, hippocampus, striatus, hypothalamus (P<0.01) of cadmium-treated rats compared with controls. Central injection of N(G) nitro-L-arginine-methylester (L-NAME) also reduced the levels of L-citrulline in the brain. 4. Both the magnitude and duration of the response were attenuated by 1.21 and 2.42 micromol SIN-1 (32+/-3 and 15+/-4 mmHg, P<0.05), or 1 micromol CaCl2 (6+/-4 mmHg, P<0.05). Selectivity of action exerted by SIN-1 was confirmed by the use of another NO donor, S-nitroso-N-acetyl-penicillamine (SNAP). Both L-Arg and D-Arg caused a mild but significant attenuation in the main phase of the pressor response evoked by cadmium. However, only L-Arg reduced the magnitude of the delayed, pressor response. Despite their similarity in ability to attenuate the cadmium-induced pressure effect, L-Arg and its isomer exerted differential biochemical changes in brain L-citrulline, as L-Arg normalized cadmium-induced reduction in L-citrulline levels, whereas i.c.v. D-Arg did not. 5. We conclude that the pressor effect of i.c.v. cadmium is due, at least in part, to reduced NO formation, consequent to inhibition of brain NO synthase. Accumulation of cadmium in the central nervous system could interfere with central mechanisms (including NO synthase) implicated in the regulation of cardiovascular function.
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Affiliation(s)
- M P Demontis
- Clinica Farmacologia, University of Sassari, Italy
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Abstract
This article presents recent data on several environmental toxins: lead, carbon disulfide, asbestos, arsenic, ozone, cadmium, vinyl chloride, fiuorocarbons, freon, and pesticides. These environmental toxins produce both hypertension and cardiac arrhythmias in most studies, and they are not necessarily related to primary lung disease and secondary heart disease. The possible mechanisms that could cause the cardiovascular diseases include (1) damage to the endothelial barrier in the vascular system, (2) activation of leukocytes and platelets, (3) initiation of plaque formation, (4) stimulation of the inflammatory response, (5) kidney-related hypertension, and (6) direct damage to cardiac and blood vessel tissue. Recommendations are that more animal, human cultured cell, and epidemiologic studies should be conducted on the environmental toxins identified in this article.
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Affiliation(s)
- A E Taylor
- Department of Physiology, University of South Alabama 36688, USA
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