Urinary Cadmium Concentration and the Risk of Ischemic Stroke

Details

• Personal Author:
  Brockman J ; Cai J ; Chen C ; Cushman M ; He K ; Kamendulis L ; MacDonald L ; Mackey J ; McClure LA ; Tsinovoi C ; Xun P
• Description:
  OBJECTIVES: To examine the association between urinary cadmium levels and the incidence of ischemic stroke and to explore possible effect modifications. METHODS: A case-cohort study was designed nested in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, including 680 adjudicated incident cases of ischemic stroke and 2,540 participants in a randomly selected subcohort. Urinary creatinine-corrected cadmium concentration was measured at baseline. Multivariable-adjusted hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were estimated with the Barlow weighting method for the Cox proportional hazards regression model. RESULTS: The median urinary cadmium concentration was 0.42 (interquartile range 0.27-0.68) µg/g creatinine. After adjustment for potential confounders, urinary cadmium was associated with increased incidence of ischemic stroke (quintile 5 vs quintile 1: HR 1.50, 95% CI 1.01-2.22, p for trend = 0.02). The observed association was more pronounced among participants in the lowest serum zinc tertile (tertile 3 vs tertile 1: HR 1.82, 95% CI 1.06-3.11, p for trend = 0.004, p for interaction = 0.05) but was attenuated and became nonsignificant among never smokers (tertile 3 vs tertile 1: never smokers: HR 1.27, 95% CI 0.80-2.03, p for trend = 0.29; ever smokers: HR 1.60, 95% CI 1.06-2.43, p for trend = 0.07, p for interaction = 0.51). CONCLUSIONS: Findings from this study suggest that cadmium exposure may be an independent risk factor for ischemic stroke in the US general population. Never smoking and maintaining a high serum zinc level may ameliorate the potential adverse effects of cadmium exposure. [Description provided by NIOSH]
• Subjects:
  Cadmium Environmental Exposure Occupational Health Risk Assessment Risk Factors Safety Urine
• Keywords:
  Cadmium Compounds Exposure Levels Health Effects Ischemic Stroke Risk Factors Statistical Analysis Urinalysis Zinc Zinc And Compounds
• ISSN:
  0028-3878
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  District of Columbia ; Indiana ; Missouri ; North Carolina ; Ohio ; OSHA Region 1 ; OSHA Region 10 ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 5 ; OSHA Region 7 ; Pennsylvania ; Vermont ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  91
• Issue:
  4
• NIOSHTIC Number:
  nn:20051929
• Citation:
  Neurology 2018 Jul; 91(4):e382-e391
• Email:
  kahe@indiana.edu
• CAS Registry Number:
  Cadmium (CAS RN 7440-43-9) ; Zinc (CAS RN 7440-66-6)
• Federal Fiscal Year:
  2018
• Peer Reviewed:
  True
• Source Full Name:
  Neurology
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:81bb177fb503376f11c4109faa41c665c0fa6ff2fe23e619a6e20b43d8858c9d0295909868262a76b1f07ce8a26cd0929a5e034568e9211eec3f7cd0d4a1f2bc
• Download URL:
  https://stacks.cdc.gov/view/cdc/211593/cdc_211593_DS1.pdf
• File Type:
  [PDF - 342.47 KB ]