J Prev Med Public Health. 2021 Nov;54(6):471-480. doi: 10.3961/jpmph.21.435. Epub 2021 Nov 30.
Association Between Cadmium Exposure and Liver Function in Adults in the United States: A Cross-sectional Study.
Journal of preventive medicine and public health = Yebang Uihakhoe chi
Dongui Hong, Jin-Young Min, Kyoung-Bok Min
Affiliations
Affiliations
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea.
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Korea.
PMID: 34875830
DOI: 10.3961/jpmph.21.435
Abstract
OBJECTIVES: Cadmium is widely used, leading to extensive environmental and occupational exposure. Unlike other organs, for which the harmful and carcinogenic effects of cadmium have been established, the hepatotoxicity of cadmium remains unclear. Some studies detected correlations between cadmium exposure and hepatotoxicity, but others concluded that they were not associated. Thus, we investigated the relationship between cadmium and liver damage in the general population.
METHODS: In total, 11 838 adult participants from National Health and Nutrition Examination Survey 1999-2015 were included. Urinary cadmium levels and the following liver function parameters were measured: alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), total bilirubin (TB), and alkaline phosphatase (ALP). Linear and logistic regression analyses were performed to assess the associations between urinary cadmium concentrations and each liver function parameter after adjusting for age, sex, race/ethnicity, annual family income, smoking status, alcohol consumption status, physical activity, and body mass index.
RESULTS: The covariate-adjusted results of the linear regression analyses showed significant positive relationships between log-transformed urinary cadmium levels and each log-transformed liver function parameter, where beta±standard error of ALT, AST, GGT, TB, and ALP were 0.049±0.008 (p<0.001), 0.030±0.006 (p<0.001), 0.093±0.011 (p<0.001), 0.034±0.009 (p<0.001), and 0.040±0.005 (p<0.001), respectively. Logistic regression also revealed statistically significant results. The odds ratios (95% confidence intervals) of elevated ALT, AST, GGT, TB, and ALP per unit increase in log-transformed urinary cadmium concentration were 1.360 (1.210 to 1.528), 1.307 (1.149 to 1.486), 1.520 (1.357 to 1.704), 1.201 (1.003 to 1.438), and 1.568 (1.277 to 1.926), respectively.
CONCLUSIONS: Chronic exposure to cadmium showed positive associations with liver damage.
Keywords: Alanine transaminase; Aspartate aminotransferases; Cadmium; Heavy metals; Liver
Publication Types
Grant support
