Urine cadmium and acute myocardial infarction among never smokers in the Danish Diet, Cancer and Health cohort
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...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-05-01
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| Series: | Environment International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0160412021000520 |
| _version_ | 1818849430470656000 |
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| author | Clara G. Sears Aslak Harbo Poulsen Melissa Eliot Chanelle J. Howe Katherine A. James James M. Harrington Nina Roswall Kim Overvad Anne Tjønneland Ole Raaschou-Nielsen Gregory A. Wellenius Jaymie Meliker |
| author_facet | Clara G. Sears Aslak Harbo Poulsen Melissa Eliot Chanelle J. Howe Katherine A. James James M. Harrington Nina Roswall Kim Overvad Anne Tjønneland Ole Raaschou-Nielsen Gregory A. Wellenius Jaymie Meliker |
| author_sort | Clara G. Sears |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T06:33:07Z |
| format | Article |
| id | doaj.art-0ce7463192d94394898b087d94c36d28 |
| institution | Directory Open Access Journal |
| issn | 0160-4120 |
| language | English |
| last_indexed | 2024-12-19T06:33:07Z |
| publishDate | 2021-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Environment International |
| spelling | doaj.art-0ce7463192d94394898b087d94c36d282022-12-21T20:32:17ZengElsevierEnvironment International0160-41202021-05-01150106428Urine cadmium and acute myocardial infarction among never smokers in the Danish Diet, Cancer and Health cohortClara G. Sears0Aslak Harbo Poulsen1Melissa Eliot2Chanelle J. Howe3Katherine A. James4James M. Harrington5Nina Roswall6Kim Overvad7Anne Tjønneland8Ole Raaschou-Nielsen9Gregory A. Wellenius10Jaymie Meliker11Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Corresponding author at: Postdoctoral Research Associate, Department of Epidemiology, Brown University School of Public Health, Box G-S121-2, Providence, RI 02912, USA.Danish Cancer Society Research Center, Copenhagen, DenmarkDepartment of Epidemiology, Brown University School of Public Health, Providence, RI, USADepartment of Epidemiology, Brown University School of Public Health, Providence, RI, USADepartment of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, CO, USACenter for Analytical Science, Research Triangle Institute, Research Triangle Park, NC, USADanish Cancer Society Research Center, Copenhagen, DenmarkDepartment of Public Health, Aarhus University, Aarhus, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, DenmarkDanish Cancer Society Research Center, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, DenmarkDanish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, DenmarkDepartment of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Department of Environmental Health, Boston University, Boston, MA, USAProgram in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY, USACadmium 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.http://www.sciencedirect.com/science/article/pii/S0160412021000520CadmiumAcute myocardial infarctionCardiovascular diseaseCase-cohort study |
| spellingShingle | Clara G. Sears Aslak Harbo Poulsen Melissa Eliot Chanelle J. Howe Katherine A. James James M. Harrington Nina Roswall Kim Overvad Anne Tjønneland Ole Raaschou-Nielsen Gregory A. Wellenius Jaymie Meliker Urine cadmium and acute myocardial infarction among never smokers in the Danish Diet, Cancer and Health cohort Environment International Cadmium Acute myocardial infarction Cardiovascular disease Case-cohort study |
| title | Urine cadmium and acute myocardial infarction among never smokers in the Danish Diet, Cancer and Health cohort |
| title_full | Urine cadmium and acute myocardial infarction among never smokers in the Danish Diet, Cancer and Health cohort |
| title_fullStr | Urine cadmium and acute myocardial infarction among never smokers in the Danish Diet, Cancer and Health cohort |
| title_full_unstemmed | Urine cadmium and acute myocardial infarction among never smokers in the Danish Diet, Cancer and Health cohort |
| title_short | Urine cadmium and acute myocardial infarction among never smokers in the Danish Diet, Cancer and Health cohort |
| title_sort | urine cadmium and acute myocardial infarction among never smokers in the danish diet cancer and health cohort |
| topic | Cadmium Acute myocardial infarction Cardiovascular disease Case-cohort study |
| url | http://www.sciencedirect.com/science/article/pii/S0160412021000520 |
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