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Association between urinary cadmium level and subclinical myocardial injury in the general population without cardiovascular disease aged ≥ 50 years

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Abstract

Cadmium (Cd) is a toxic heavy metal linked to an increased risk of cardiovascular disease (CVD). But the relationship between urinary Cd (U-Cd) and electrocardiographic subclinical myocardial injury (SC-MI) in older people is unclear. This study evaluated the connection between U-Cd and SC-MI in people who did not have CVD. The study involved 4269 participants from the National Health and Nutrition Examination Survey III(NHANES III) aged ≥ 50 years and had no history of CVD. The relationship between U-Cd and cardiac infarction/injury score (CIIS) was assessed by multivariable linear regression. Whether U-Cd and SC-MI were correlated was determined by multivariate logistic regression, restricted cubic spline, and subgroup analysis. There was a significant association between U-Cd and CIIS (β, 1.04, 95% confidence interval (CI): 0.39–1.69; P = 0.003) in the highest quartile and fully adjusted model. After adjusting for relevant confounders, multivariable logistic regression showed that participants in the highest quartile of U-Cd had a greater chance of having SC-MI than those in the first ( OR (95% CI), 1.37(1.13,1.66), P for trend = 0.003), and this relationship was especially strong among hypertensive participants. And a positive linear correlation between U-Cd and the prevalence of SC-MI was shown by restricted cubic spline analysis. U-Cd may be a novel risk element for SC-MI because it is independently and linearly linked to CIIS and SC-MI.

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Data availability

The National Health and Nutrition Examination Survey (NHANES) is an open-access resource, and data are available at https://www.cdc.gov/nchs/nhanes.

Abbreviations

Cd :

Cadmium

CVD :

Cardiovascular disease

ASCVD :

Atherosclerotic cardiovascular disease

AMI :

Acute myocardial infarction

IHD :

Ischemic heart disease

U-Cd :

Urinary cadmium

SC-MI :

Subclinical myocardial injury

CIIS :

Cardiac infarction/injury score

CDC:

Centers for Disease Control and Prevention

PIR :

Poverty income ratio

SBP :

Systolic blood pressure

DBP :

Diastolic blood pressure

PR :

Pulse rate

BMI :

Body mass index

TC :

Total cholesterol

HDL-C :

High-density lipoprotein cholesterol

TG :

Triglycerides

CRP :

C-reactive protein

APOB :

Apolipoprotein B

FIB :

Fibrinogen

C-p :

C-peptide

BUN :

Blood urea nitrogen

UA :

Uric acid

ROS :

Reactive oxygen species

NADPH :

Nicotinamide adenine dinucleotide phosphate oxidase

SE :

Standard error

CI :

Confidence interval

NHANES III :

National Health and Nutrition Examination Survey III

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Author notes

  1. Yu-Jie Wu and Si-Bo Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China

    Yu-Jie Wu, Si-Bo Wang, Jia-Teng Sun, Ling-Feng Gu, Ze-Mu Wang, Bo Deng, Hao Wang & Lian-Sheng Wang

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  1. Yu-Jie Wu
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Contributions

Yu-Jie Wu and Si-Bo Wang: concept development, methodology, software, writing-original draft, visualization. Jia-Teng Sun, Ling-Feng Gu, Ze-Mu Wang, Bo Deng, and Hao Wang: writing-review and editing, data curation, validation. Lian-Sheng Wang: concept development, project management, editing, reviewing, and writing supervision.

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Correspondence to Lian-Sheng Wang.

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Wu, YJ., Wang, SB., Sun, JT. et al. Association between urinary cadmium level and subclinical myocardial injury in the general population without cardiovascular disease aged ≥ 50 years. Environ Sci Pollut Res 30, 77551–77559 (2023). https://doi.org/10.1007/s11356-023-27923-0

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