Association between Urinary Cadmium-to-Zinc Intake Ratio and Adult Mortality in a Follow-Up Study of NHANES 1988–1994 and 1999–2004

Abstract

Cadmium (Cd) is a toxic heavy metal associated with increased mortality, but the effect of zinc (Zn) intake on the association between Cd and mortality is unknown. The objective of this study was to examine the association of urinary Cd to Zn intake ratio (Cd/Zn ratio) and mortality risk. In total, 15642 US adults in NHANES 1988–1994 and 1999–2004 were followed until 2011 (15-year mean follow-up). Of the 5367 total deaths, 1194 were attributed to cancer and 1677 were attributed to CVD. After adjustment for potential confounders, positive associations were observed between urinary Cd and all-cause mortality (HR for highest vs. lowest quartile: 1.38; 95% CI: 1.14–1.68) and cancer mortality (HR: 1.54; CI: 1.05–2.27). Urinary Cd was positively associated with cancer mortality among the lowest Zn consumers, and the association diminished among the highest Zn consumers. Positive relationships were observed between the Cd/Zn ratio and all-cause mortality (HR: 1.54; CI: 1.23–1.93), cancer mortality (HR: 1.65; CI: 1.11–2.47) and CVD mortality (HR: 1.49; CI: 1.18–1.88). In conclusion, these findings indicate that Zn intake may modify the association between Cd and mortality. Furthermore, the Cd/Zn ratio, which was positively associated with mortality from all causes, cancer, and CVD, may be an important predictor of mortality.

Association of Serum 25(OH)D, Cadmium, CRP With All-Cause, Cause-Specific Mortality: A Prospective Cohort Study

“…A study with data from NHANES found that zinc intake may change the association between cadmium and mortality. In addition, the Cd/Zn ratio was positively correlated with all-cause mortality, cancer, and CVD mortality ( 34 ). Our research paid more attention to the relationship between serum 25(OH)D, cadmium, and CRP with mortality among people in diabetic and non-diabetic.…”

Increased serum levels of cadmium are associated with an elevated risk of cardiovascular disease in adults

“…Although a study involving 15,624 United States (US) adults showed that urinary levels of Cd might be associated with all-cause mortality, more than 30% of which was attributed to CVD, no signi cant association was observed between Cd levels and CVD mortality. (Kim et al 2019) Given that the levels of urinary Cd are sensitive to kidney function and physical activity, they cannot be used to accurately re ect exposure levels. , Munoz et al 2020 The association of blood levels of Cd with CVD was studied in another population, and it was shown that elevated levels of Cd were associated with an elevated risk of CVD in adults under 60 years old.…”