Cadmium exposure is accompanied by increased prevalence and future growth of atherosclerotic plaques in 64-year-old women.
OBJECTIVE
There is currently widespread exposure to the toxic metal cadmium through the diet as well as through smoking, and it has been suggested that cadmium exposure may increase the risk of cardiovascular disease. Here we examined whether cadmium exposure is associated with prevalence and growth of atherosclerotic plaques in the carotid arteries.


METHODS
The analyses were performed in a screening-based cohort of 64-year-old Caucasian women with stratified, random selection to groups with normal glucose tolerance, impaired glucose tolerance and diabetes (n = 599). We measured cadmium concentrations in blood and urine at baseline. In addition, we performed ultrasound examination to determine the prevalence and area of atherosclerotic plaques in the carotid arteries and assessed smoking history and other cardiovascular risk factors at baseline and at a follow-up examination after a mean of 5.4 years.


RESULTS
At baseline, blood cadmium levels were associated with increased risk of plaque and a large plaque area after adjustment for confounders. In women who had never smoked, blood cadmium levels correlated positively with plaque area at baseline. The occurrence of large plaques and the change in plaque area at follow-up were associated with blood and creatinine-corrected urinary cadmium concentrations at baseline after adjustment for confounders. Blood and urine cadmium levels added information to established cardiovascular risk factors in predicting progress of atherosclerosis.


CONCLUSIONS
We have shown that cadmium levels in blood and urine are independent factors associated with the development of atherosclerotic plaques at baseline as well as prospectively. This novel observation emphasizes the need to consider cadmium as a pro-atherogenic pollutant.
Sahlgrenska Center for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden. bjorn.fagerberg@wlab.gu.se
Björn
B
Fagerberg
Göran
G
Bergström
Jan
J
Borén
Lars
L
Barregard
D002104:Cadmium / Q000097:blood / Q000652:urine; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D015986:Confounding Factors, Epidemiologic; D004781:Environmental Exposure / Q000009:adverse effects / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005506:Food Contamination / Q000032:analysis / Q000517:prevention & control; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects / Q000517:prevention & control; D008875:Middle Aged; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000378:metabolism; D013548:Sweden / Q000453:epidemiology; D018616:Ultrasonography, Doppler, Duplex
D002104:Cadmium