Urinary Cadmium Concentration and the Risk of Ischemic Stroke

Overview

Journal Neurology

Specialty Neurology

Date 2018 Jun 24

PMID 29934425

Citations 16

Authors

Cheng Chen

Pengcheng Xun

Cari Tsinovoi

Leslie A McClure

John Brockman

Leslie MacDonald

Mary Cushman

Jianwen Cai

Lisa Kamendulis

Jason Mackey

Ka He

Affiliations

Soon will be listed here.

Abstract

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, 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, for trend = 0.004, 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, for trend = 0.29; ever smokers: HR 1.60, 95% CI 1.06-2.43, for trend = 0.07, 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.

Citing Articles

Association of Urinary Cadmium Concentration With Cognitive Impairment in US Adults: A Longitudinal Cohort Study.

Lu L, Zhang Y, Angley M, Bejerano S, Brockman J, McClure L Neurology. 2024; 103(7):e209808.

PMID: 39231381 PMC: 11373676. DOI: 10.1212/WNL.0000000000209808.

Exposure to Environmental Toxins: Potential Implications for Stroke Risk via the Gut- and Lung-Brain Axis.

Ruggles A, Benakis C Cells. 2024; 13(10.

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Urinary cadmium was linearly and positively associated with cardiac infarction/injury score and subclinical myocardial injury in the general population without cardiovascular diseases and chronic kidney disease.

Qiang Y, Hao M, Yang J Int Urol Nephrol. 2023; 56(5):1677-1685.

PMID: 37898564 DOI: 10.1007/s11255-023-03853-1.

Integrative Approaches in Acute Ischemic Stroke: From Symptom Recognition to Future Innovations.

Saceleanu V, Toader C, Ples H, Covache-Busuioc R, Costin H, Bratu B Biomedicines. 2023; 11(10).

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Occupational Risk Factors for Stroke: A Comprehensive Review.

Yang M, Yoo H, Kim S, Kwon O, Nam M, Pan K J Stroke. 2023; 25(3):327-337.

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