Urinary cadmium and stroke - a case-cohort study in Danish never-smokers

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Urinary cadmium and stroke - a case-cohort study in Danish never-smokers. / Poulsen, Aslak Harbo; Sears, Clara G; Harrington, James; Howe, Chanelle J; James, Katherine A; Roswall, Nina; Overvad, Kim; Tjønneland, Anne; Wellenius, Gregory A; Meliker, Jaymie; Raaschou-Nielsen, Ole.

I: Environmental Research, Bind 200, 111394, 09.2021.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Harvard

Poulsen, AH, Sears, CG, Harrington, J, Howe, CJ, James, KA, Roswall, N, Overvad, K, Tjønneland, A, Wellenius, GA, Meliker, J & Raaschou-Nielsen, O 2021, 'Urinary cadmium and stroke - a case-cohort study in Danish never-smokers', Environmental Research, bind 200, 111394. https://doi.org/10.1016/j.envres.2021.111394

APA

Poulsen, A. H., Sears, C. G., Harrington, J., Howe, C. J., James, K. A., Roswall, N., Overvad, K., Tjønneland, A., Wellenius, G. A., Meliker, J., & Raaschou-Nielsen, O. (2021). Urinary cadmium and stroke - a case-cohort study in Danish never-smokers. Environmental Research, 200, [111394]. https://doi.org/10.1016/j.envres.2021.111394

CBE

Poulsen AH, Sears CG, Harrington J, Howe CJ, James KA, Roswall N, Overvad K, Tjønneland A, Wellenius GA, Meliker J, Raaschou-Nielsen O. 2021. Urinary cadmium and stroke - a case-cohort study in Danish never-smokers. Environmental Research. 200:Article 111394. https://doi.org/10.1016/j.envres.2021.111394

MLA

Vancouver

Poulsen AH, Sears CG, Harrington J, Howe CJ, James KA, Roswall N o.a. Urinary cadmium and stroke - a case-cohort study in Danish never-smokers. Environmental Research. 2021 sep.;200. 111394. https://doi.org/10.1016/j.envres.2021.111394

Author

Poulsen, Aslak Harbo ; Sears, Clara G ; Harrington, James ; Howe, Chanelle J ; James, Katherine A ; Roswall, Nina ; Overvad, Kim ; Tjønneland, Anne ; Wellenius, Gregory A ; Meliker, Jaymie ; Raaschou-Nielsen, Ole. / Urinary cadmium and stroke - a case-cohort study in Danish never-smokers. I: Environmental Research. 2021 ; Bind 200.

Bibtex

@article{9cb228b52b79483194392c874454b98e,
title = "Urinary cadmium and stroke - a case-cohort study in Danish never-smokers",
abstract = "BACKGROUND: and Purpose: Cadmium has been associated with risk of cardiovascular events, including stroke. Human cadmium exposure occurs primarily through diet and tobacco smoke. Recent cohort studies have found an association with stroke, but residual confounding from smoking, could not be ruled out. We therefore conducted a case-cohort study to evaluate whether cadmium is associated with stroke in never-smokers.METHODS: The Danish Diet Cancer and Health cohort consists of Danes 50-64 years old, recruited in 1993-1997. From never-smoking cohort members without previous cancer or stroke we sampled a sub-cohort of 1200 persons. We also identified all (n = 534) cases in the cohort with a validated stroke diagnosis between baseline and 2009. We quantified cadmium and creatinine concentrations from baseline urine samples and used cadmium per creatinine as our main exposure metric. We used Cox proportional hazards models to estimate hazard ratios (HRs) with age as time scale and adjusting for BMI, education and urinary cotinine with and without stratification by sex.RESULTS: The median urinary cadmium concentration was 0.21 μg cadmium/g creatinine in cases and 0.19 μg/g in the sub-cohort. The majority (83%) of stroke cases were diagnosed with ischemic stroke. The HR for stroke in the highest quartile of exposure (median 0.44 μg/g creatinine) was 1.11 (95% CI: 0.79-1.54) compared with the lowest quartile (median 0.10 μg/g creatinine). The HR per inter quartile range (IQR, 0.19 μg/g creatinine) was 1.02 (95% CI: 0.92-1.12). Among men, the HR per IQR higher levels of cadmium (0.16 μg/g creatinine) was 1.18 (95% CI: 0.92-1.52), and 1.00 (95% CI: 0.89-1.12) among women. Adjusting for creatinine or using osmolality instead of creatinine standardization generally attenuated observed relationships.CONCLUSIONS: Our results do not support that low levels of cadmium exposure among never-smokers are strongly associated with risk of stroke, although results varied somewhat by sex and method of accounting for urinary dilution.",
keywords = "cadmium, cardiovascular disease, case-cohort study, stroke",
author = "Poulsen, {Aslak Harbo} and Sears, {Clara G} and James Harrington and Howe, {Chanelle J} and James, {Katherine A} and Nina Roswall and Kim Overvad and Anne Tj{\o}nneland and Wellenius, {Gregory A} and Jaymie Meliker and Ole Raaschou-Nielsen",
note = "Copyright {\textcopyright} 2021 Elsevier Inc. All rights reserved.",
year = "2021",
month = sep,
doi = "10.1016/j.envres.2021.111394",
language = "English",
volume = "200",
journal = "Environmental Research",
issn = "0013-9351",
publisher = "Academic Press",

}

RIS

TY - JOUR

T1 - Urinary cadmium and stroke - a case-cohort study in Danish never-smokers

AU - Poulsen, Aslak Harbo

AU - Sears, Clara G

AU - Harrington, James

AU - Howe, Chanelle J

AU - James, Katherine A

AU - Roswall, Nina

AU - Overvad, Kim

AU - Tjønneland, Anne

AU - Wellenius, Gregory A

AU - Meliker, Jaymie

AU - Raaschou-Nielsen, Ole

N1 - Copyright © 2021 Elsevier Inc. All rights reserved.

PY - 2021/9

Y1 - 2021/9

N2 - BACKGROUND: and Purpose: Cadmium has been associated with risk of cardiovascular events, including stroke. Human cadmium exposure occurs primarily through diet and tobacco smoke. Recent cohort studies have found an association with stroke, but residual confounding from smoking, could not be ruled out. We therefore conducted a case-cohort study to evaluate whether cadmium is associated with stroke in never-smokers.METHODS: The Danish Diet Cancer and Health cohort consists of Danes 50-64 years old, recruited in 1993-1997. From never-smoking cohort members without previous cancer or stroke we sampled a sub-cohort of 1200 persons. We also identified all (n = 534) cases in the cohort with a validated stroke diagnosis between baseline and 2009. We quantified cadmium and creatinine concentrations from baseline urine samples and used cadmium per creatinine as our main exposure metric. We used Cox proportional hazards models to estimate hazard ratios (HRs) with age as time scale and adjusting for BMI, education and urinary cotinine with and without stratification by sex.RESULTS: The median urinary cadmium concentration was 0.21 μg cadmium/g creatinine in cases and 0.19 μg/g in the sub-cohort. The majority (83%) of stroke cases were diagnosed with ischemic stroke. The HR for stroke in the highest quartile of exposure (median 0.44 μg/g creatinine) was 1.11 (95% CI: 0.79-1.54) compared with the lowest quartile (median 0.10 μg/g creatinine). The HR per inter quartile range (IQR, 0.19 μg/g creatinine) was 1.02 (95% CI: 0.92-1.12). Among men, the HR per IQR higher levels of cadmium (0.16 μg/g creatinine) was 1.18 (95% CI: 0.92-1.52), and 1.00 (95% CI: 0.89-1.12) among women. Adjusting for creatinine or using osmolality instead of creatinine standardization generally attenuated observed relationships.CONCLUSIONS: Our results do not support that low levels of cadmium exposure among never-smokers are strongly associated with risk of stroke, although results varied somewhat by sex and method of accounting for urinary dilution.

AB - BACKGROUND: and Purpose: Cadmium has been associated with risk of cardiovascular events, including stroke. Human cadmium exposure occurs primarily through diet and tobacco smoke. Recent cohort studies have found an association with stroke, but residual confounding from smoking, could not be ruled out. We therefore conducted a case-cohort study to evaluate whether cadmium is associated with stroke in never-smokers.METHODS: The Danish Diet Cancer and Health cohort consists of Danes 50-64 years old, recruited in 1993-1997. From never-smoking cohort members without previous cancer or stroke we sampled a sub-cohort of 1200 persons. We also identified all (n = 534) cases in the cohort with a validated stroke diagnosis between baseline and 2009. We quantified cadmium and creatinine concentrations from baseline urine samples and used cadmium per creatinine as our main exposure metric. We used Cox proportional hazards models to estimate hazard ratios (HRs) with age as time scale and adjusting for BMI, education and urinary cotinine with and without stratification by sex.RESULTS: The median urinary cadmium concentration was 0.21 μg cadmium/g creatinine in cases and 0.19 μg/g in the sub-cohort. The majority (83%) of stroke cases were diagnosed with ischemic stroke. The HR for stroke in the highest quartile of exposure (median 0.44 μg/g creatinine) was 1.11 (95% CI: 0.79-1.54) compared with the lowest quartile (median 0.10 μg/g creatinine). The HR per inter quartile range (IQR, 0.19 μg/g creatinine) was 1.02 (95% CI: 0.92-1.12). Among men, the HR per IQR higher levels of cadmium (0.16 μg/g creatinine) was 1.18 (95% CI: 0.92-1.52), and 1.00 (95% CI: 0.89-1.12) among women. Adjusting for creatinine or using osmolality instead of creatinine standardization generally attenuated observed relationships.CONCLUSIONS: Our results do not support that low levels of cadmium exposure among never-smokers are strongly associated with risk of stroke, although results varied somewhat by sex and method of accounting for urinary dilution.

KW - cadmium

KW - cardiovascular disease

KW - case-cohort study

KW - stroke

U2 - 10.1016/j.envres.2021.111394

DO - 10.1016/j.envres.2021.111394

M3 - Journal article

C2 - 34062200

VL - 200

JO - Environmental Research

JF - Environmental Research

SN - 0013-9351

M1 - 111394

ER -