title: Environmental cadmium and lead exposures and age-related macular degeneration in U.S. adults: the National Health and Nutrition Examination Survey 2005 to 2008.
abstract: Age-related macular degeneration (AMD) is a complex disease resulting from the interplay of genetic predisposition and environmental exposures, and has been linked to oxidative stress and inflammatory mechanisms. Lead and cadmium can accumulate in human retinal tissues and may damage the retina through oxidative stress, and may thereby play a role in the development of AMD. We examined associations between blood lead, blood cadmium, and urinary cadmium concentrations and the presence of AMD in 5390 participants aged 40 years and older with blood lead and blood cadmium measures and a subsample of 1548 with urinary cadmium measures in the 2005-2008 National Health and Nutrition Examination Surveys. AMD was identified by grading retinal photographs with a modification of the Wisconsin Age-Related Maculopathy Grading System. The weighted prevalence of AMD was 6.6% (n=426). Controlling for age, gender, race/ethnicity, education and body mass index, adults in the highest blood cadmium quartile had higher odds of AMD compared to the lowest quartile (odds ratio [OR], 1.56; 95% CI, 1.02-2.40), with a significant trend across quartiles (p-trend=0.02). After further adjustment for pack-years of cigarette smoking, estimates were somewhat attenuated (OR, 1.43; 95% CI, 0.91-2.27; p-trend=0.08). Similar associations were found with urinary cadmium. The association between urinary cadmium and AMD was stronger in non-Hispanic whites (NHW) than in non-Hispanic blacks (NHB) (OR, 3.31; 95% CI, 1.37-8.01 for levels above versus below the median among NHW; OR,1.45; 95% CI, 0.40-5.32 for levels above versus below the median among NHB; p-interaction=0.03). We found no association between blood lead levels and AMD. Higher cadmium body burden may increase risk of AMD, particularly among non-Hispanic white individuals; however, additional studies are needed before firm conclusions can be drawn.
authors: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
authors: Erin W
authors: EW
authors: Wu
authors: Division of Preventive Medicine, Brigham & Women׳s Hospital, Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; Center for Translational Medicine, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors: Debra A
authors: DA
authors: Schaumberg
authors: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA. Electronic address: sungkyun@umich.edu.
authors: Sung Kyun
authors: SK
authors: Park
mesh_terms: D000368:Aged; D002104:Cadmium / Q000097:blood / Q000633:toxicity* / Q000652:urine; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007854:Lead / Q000097:blood / Q000633:toxicity*; D008268:Macular Degeneration / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D014481:United States / Q000453:epidemiology
chemical_list: D002104:Cadmium; D007854:Lead
keywords: Age-related macular degeneration; Cadmium; Lead; NHANES