Association between urinary cadmium levels and prediabetes in the NHANES 2005–2010 population

Abstract

Evidence suggests an association between exposure to cadmium and dysglycemia. To investigate this matter, we examined the relationship between urinary cadmium and prediabetes in the cross sectional National Health and Nutrition Examination Survey (NHANES). NHANES participants for the years 2005 through 2010 aged ≥40 years were included in the analysis. Participants with nephropathy, overt diabetes, or missing required data were excluded. To assess the non-linear relationship between cadmium and Prediabetes, non-parametric logistic regression with B spline expansion of urinary cadmium/creatinine ratio was performed. This analysis revealed a complex non-linear association between higher cadmium levels and prediabetes. This relationship persisted, though with varying magnitudes across smoking groups (never smokers, moderate smokers, heavy smokers). In a conventional logistic regression analysis, this relationship was less evident with significantly increased OR for prediabetes was found in the highest quintile of urine cadmium compared to the lowest quintile in the overall population and in moderate smokers. In an age stratified analysis, a significant linear association was found only in the age groups 60–69 and ≥70. We conclude that there is a significant non-linear, complex relationship between urinary Cd levels, age, smoking habits and odds of prediabetes.

Kidney Cadmium Toxicity, Diabetes and High Blood Pressure: The Perfect Storm

“…In NHANES 2005-2010, Wallia et al (2014) found that an increased pre-diabetic risk among non-smokers were associated with urinary Cd levels above 1.375 µg/g creatinine, which were greater than the urinary levels associated with pre-diabetic risk in moderate and heavy smokers. Increased pre-diabetic risk among moderate smokers was associated with urinary Cd levels of 0.646 µg/g creatinine, while increased pre-diabetic risk among heavy smokers was associated with urinary Cd levels, ranging between 0.329 and 0.454 µg/g creatinine and > 0.711 µg/g creatinine.…”

“…The U.S. population studies show that blood Cd level as low as 0.4 µg/L is associated with an increased risk of hypertension in Caucasian women (OR 1.54, 95% CI 1.08-2.19) and in Mexican-American women (OR 2.38, 95% CI 1.28-4.40) and that the prevalence of hypertension in Black, Caucasian and Mexican-American women (men) in the U.S. NHANES 1999-2006 was 40.7 (30.1), 32.2 (36.2) and 19.4 (16.7) %, respectively. Increased diabetic risk by Cd exposure has been reported for the Korean population (Son et al 2015), Chinese population (Nie et al 2016) and the U.S. population (Schwartz et al 2003;Wallia et al 2014). In the Chinese study, a synergistic effect of Cd exposure and obesity on diabetic risk has also been noted (Nie et al 2016).…”

“…Pre-diabetes, Wallia et al (2014), U.S. NHANES 2005-2010, n2398, aged ≥ 40 yrs, without albuminuria, diabetes or chronic kidney disease.…”

“…Positive association between cadmium exposure and diabetic risk: Evidence for a potential effect of Cd exposure on diabetic risk comes from a Korean study (Son et al 2015), two cycles of the U.S. population studies; NHANES (1988NHANES ( -1994 and NHANES (2005NHANES ( -2010 (Schwartz et al 2003;Wallia et al 2014) and a Chinese study (see Table 1). …”

“…Increased pre-diabetic risk among moderate smokers was associated with urinary Cd levels of 0.646 µg/g creatinine, while increased pre-diabetic risk among heavy smokers was associated with urinary Cd levels, ranging between 0.329 and 0.454 µg/g creatinine and > 0.711 µg/g creatinine. Wallia et al (2014) have attributed the increased pre-diabetic risk in non-smokers to Cd toxicity in pancreatic β-cells, given a particularly strong association of urinary Cd (body burden) and risk of pre-diabetes in the elderly, whose Cd levels in β-cells could be expected to have exceeded a threshold limit due to longer exposure durations. Loss of pancreatic β-cells due to Cd-induced apoptosis may thus be another mechanism for effects of Cd exposure on pre-diabetic risk.…”