Urine cadmium and acute myocardial infarction among never smokers in the Danish Diet, Cancer and Health cohort

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  • Clara G Sears, Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
  • Aslak Harbo Poulsen, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark., Danmark
  • Melissa Eliot, Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
  • Chanelle J Howe, Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
  • Katherine A James, Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, CO, USA
  • James M Harrington, Center for Analytical Science, Research Triangle Institute, Research Triangle Park, NC, USA
  • Nina Roswall, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark., Danmark
  • Kim Overvad
  • Anne Tjønneland, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark., Department of Public Health, University of Copenhagen, 1123, Copenhagen, Denmark., Danmark
  • Ole Raaschou-Nielsen
  • Gregory A Wellenius, Department of Epidemiology, Brown University School of Public Health, Providence, RI, Department of Environmental Health, Boston University, USA
  • Jaymie Meliker, Program in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook University, USA

Cadmium exposure has been associated with cardiovascular disease. Cigarette smoking is a key source of cadmium exposure and thus a potential confounder in observational studies of environmental cadmium and cardiovascular disease that include tobacco smokers. We leveraged up to 20 years of follow-up in the Danish Diet, Cancer and Health cohort to test the hypothesis that cadmium exposure is associated with acute myocardial infarction (AMI) among people who never smoked. Between 1993 and 1997, 19,394 never-smoking participants (ages 50-64 years) were enrolled and provided a urine sample. From this sample, we randomly selected a subcohort of 600 males and 600 females. We identified 809 AMI cases occurring between baseline and the end of 2015 using the Danish National Patient Registry. We quantified cadmium, creatinine, and osmolality in baseline urine samples. Using an unweighted case-cohort approach, we estimated adjusted hazard ratios (aHR) for AMI in Cox proportional hazards models with age as the time axis. Participants had relatively low concentrations of urinary cadmium, as expected for never smokers (median = 0.20; 25th, 75th = 0.13, 0.32 μg cadmium/g creatinine). We did not find strong evidence to support an association between higher urinary cadmium and AMI when comparing the highest versus lowest quartile (aHR = 1.16; 95% CI: 0.86 - 1.56) and per IQR increment in cadmium concentration (aHR = 1.02; 95% CI: 0.93 - 1.12). Results were not materially different across strata defined by sex. Results were generally similar using creatinine or osmolality to account for differences in urine dilution. While cadmium exposure has been identified as a risk factor for cardiovascular disease, we did not find strong evidence that urinary cadmium at relatively low-levels is associated with AMI among people who have never smoked.

OriginalsprogEngelsk
Artikelnummer106428
TidsskriftEnvironment International
Vol/bind150
ISSN0160-4120
DOI
StatusE-pub ahead of print - 8 feb. 2021

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