title: Cigarette smoking, cadmium exposure, and zinc intake on obstructive lung disorder.
abstract: OBJECTIVE
  This study examined whether zinc intake was associated with lower risk of smoking-induced obstructive lung disorder through interplay with cadmium, one of major toxicants in cigarette smoke.
  
  
  METHODS
  Data were obtained from a sample of 6,726 subjects aged 40+ from the Third National Health and Nutrition Examination Survey. The forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured using spirometry. Gender-, ethnicity-, and age-specific equations were used to calculate the lower limit of normal (LLN) to define obstructive lung disorder as: observed FEV1/FVC ratio and FEV1 below respective LLN. Zinc intake was assessed by questionnaire. Logistic regression analysis was applied to investigate the associations of interest.
  
  
  RESULTS
  The analyses showed that an increased prevalence of obstructive lung disorder was observed among individuals with low zinc intake regardless of smoking status. The adjusted odds of lung disorder are approximately 1.9 times greater for subjects in the lowest zinc-intake tertile than those in the highest tertile (odds ratio = 1.89, 95% confidence interval = 1.22-2.93). The effect of smoking on lung function decreased considerably after adjusting for urinary cadmium. Protective association between the zinc-to-cadmium ratio (log-transformed) and respiratory risk suggests that zinc may play a role in smoking-associated lung disorder by modifying the influence of cadmium.
  
  
  CONCLUSIONS
  While zinc intake is associated with lower risk of obstructive lung disorder, the role of smoking cession and/or prevention are likely to be more important given their far greater effect on respiratory risk. Future research is warranted to explore the mechanisms by which zinc could modify smoking-associated lung disease.
authors.affiliation: Cardiovascular Center and Health Management Center, National Taiwan University Hospital Yun-Lin Branch, Dou-Liou City, Taiwan. jouweilin@yahoo.com
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Lin
authors.forename: James L
authors.initials: JL
authors.lastname: Caffrey
authors.forename: Man-Huei
authors.initials: MH
authors.lastname: Chang
authors.forename: Nicole
authors.initials: N
authors.lastname: Dowling
authors.forename: Jou-Wei
authors.initials: JW
authors.lastname: Lin
mesh_terms: D000328:Adult; D002104:Cadmium / Q000009:adverse effects* / Q000652:urine; D019587:Dietary Supplements; D005260:Female; D005541:Forced Expiratory Volume; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008173:Lung Diseases, Obstructive / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014797:Vital Capacity; D015032:Zinc / Q000008:administration & dosage*
chemical_list: D002104:Cadmium; D015032:Zinc
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