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Cadmium and peripheral arterial disease: gender differences in the 1999-2004 US National Health and Nutrition Examination Survey.
Tellez-Plaza-M; Navas-Acien-A; Crainiceanu-CM; Sharrett-AR; Guallar-E
Am J Epidemiol 2010 Sep; 172(6):671-681
Gender differences in the association of blood and urine cadmium concentrations with peripheral arterial disease (PAD) were evaluated by using data from 6,456 US adults aged >/= 40 years who participated in the 1999-2004 National Health and Nutrition Examination Survey. PAD was defined as an ankle-brachial blood pressure index of <0.9 in at least one leg. For men, the adjusted odds ratios for PAD comparing the highest with the lowest quintiles of blood and urine cadmium concentrations were 1.82 (95% confidence interval (CI): 0.82, 4.05) and 4.90 (95% CI: 1.55, 15.54), respectively, with a progressive dose-response relation and no difference by smoking status. For women, the corresponding odds ratios were 1.19 (95% CI: 0.66, 2.16) and 0.56 (95% CI: 0.18, 1.71), but there was evidence of effect modification by smoking: among women ever smokers, there was a positive, progressive dose-response relation; among women never smokers, there was a U-shaped dose-response relation. Higher blood and urine cadmium levels were associated with increased prevalence of PAD, but women never smokers showed a U-shaped relation with increased prevalence of PAD at very low cadmium levels. These findings add to the concern of increased cadmium exposure as a cardiovascular risk factor in the general population.
Epidemiology; Humans; Men; Women; Sex-factors; Workers; Cadmium-compounds; Metal-compounds; Metallic-compounds; Health-surveys; Blood-vessels; Veins; Muscle-physiology; Circulatory-system; Blood-pressure; Urinalysis; Statistical-analysis; Age-groups; Dose-response; Smoking; Cardiovascular-disease; Cardiovascular-function; Risk-factors; Author Keywords: cadmium; health surveys; metals; peripheral vascular diseases; sex characteristics
Dr. Ana Navas-Acien, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room W7033B, Baltimore, MD 21205
Issue of Publication
American Journal of Epidemiology
Johns Hopkins University
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division