The association between serum cadmium and cardiovascular diseases is modified by alcohol consumption with a gender difference

Abstract

Cadmium is a ubiquitous environmental pollutant and carcinogenic heavy metal. There was a clear association between elevated serum cadmium levels and cardiovascular diseases (CVDs), however, this association varied by subgroup, and previous studies have not explored the sex differences in this association or investigated whether alcohol consumption affects this association. Here, we enrolled 37,729 participants from 11 cycles (1999–2020) of the National Health and Nutrition Examination Survey (NHANES) to explore the association between serum cadmium and CVDs in depth. After grouping the population by gender and adjusting for potential confounders using a multivariable logistic regression modeling strategy, we observed an independent association between serum cadmium levels and CVDs. Moreover, we further included alcohol consumption as a subgroup variable, performed a subgroup multivariable logistic regression to observe whether this association was modified by alcohol consumption. We found that serum cadmium levels were significantly positively associated with most CVDs, and that this association was gender-differentiated, which was also modified by alcohol consumption. Our study provides a new perspective for further exploring the relationship between serum cadmium levels and CVDs.