title: Cadmium exposure and atherosclerotic carotid plaques--results from the Malmö diet and Cancer study.
abstract: BACKGROUND
  Epidemiological studies indicate that cadmium exposure through diet and smoking is associated with increased risk of cardiovascular disease. There are few data on the relationship between cadmium and plaques, the hallmark of underlying atherosclerotic disease.
  
  
  OBJECTIVE
  To examine the association between exposure to cadmium and the prevalence and size of atherosclerotic plaques in the carotid artery.
  
  
  METHODS
  A population sample of 4639 Swedish middle-aged women and men was examined in 1991-1994. Carotid plaque was determined by B-mode ultrasound. Cadmium in blood was analyzed by inductively coupled plasma mass spectrometry.
  
  
  RESULTS
  Comparing quartile 4 with quartile 1 of blood cadmium, the odds ratio (OR) for prevalence of any plaque was 1.9 (95% confidence interval 1.6-2.2) after adjustment for sex and, age; 1.4 (1.1-1.8) after additional adjustment for smoking status; 1.4 (1.1-1.7) after the addition of education level and life style factors; 1.3 (1.03-1.8) after additional adjustment for risk factors and predictors of cardiovascular disease. No effect modification by sex was found in the cadmium-related prevalence of plaques. Similarly, ORs for the prevalence of small and large plaques were after full adjustment 1.4 (1.0-2.1) and 1.4 (0.9-2.0), respectively. The subgroup of never smokers showed no association between cadmium and atherosclerotic plaques.
  
  
  CONCLUSIONS
  These results extend previous studies on cadmium exposure and clinical cardiovascular events by adding data on the association between cadmium and underlying atherosclerosis in humans. The role of smoking remains unclear. It may both cause residual confounding and be a source of pro-atherogenic cadmium exposure.
authors.affiliation: Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden. Electronic address: bjorn.fagerberg@wlab.gu.se.
authors.forename: Björn
authors.initials: B
authors.lastname: Fagerberg
authors.affiliation: Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, SE 413 45 Gothenburg, Sweden. Electronic address: lars.barregard@amm.gu.se.
authors.forename: Lars
authors.initials: L
authors.lastname: Barregard
authors.affiliation: Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, SE 413 45 Gothenburg, Sweden. Electronic address: gerd.sallsten@amm.gu.se.
authors.forename: Gerd
authors.initials: G
authors.lastname: Sallsten
authors.affiliation: Department of Clinical Chemistry, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden. Electronic address: niklas.forsgard@vgregion.se.
authors.forename: Niklas
authors.initials: N
authors.lastname: Forsgard
authors.affiliation: Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, CRC, Jan Waldenströms gata 35, Skane University Hospital, Malmö, 205 02 Malmö, Sweden. Electronic address: gerd.ostling@med.lu.se.
authors.forename: Gerd
authors.initials: G
authors.lastname: Ostling
authors.affiliation: Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, CRC, Jan Waldenströms gata 35, Skane University Hospital, Malmö, 205 02 Malmö, Sweden. Electronic address: margaretha.persson@med.lu.se.
authors.forename: Margaretha
authors.initials: M
authors.lastname: Persson
authors.affiliation: Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, CRC, Jan Waldenströms gata 35, Skane University Hospital, Malmö, 205 02 Malmö, Sweden. Electronic address: yan.borne@med.lu.se.
authors.forename: Yan
authors.initials: Y
authors.lastname: Borné
authors.affiliation: Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, CRC, Jan Waldenströms gata 35, Skane University Hospital, Malmö, 205 02 Malmö, Sweden. Electronic address: gunnar.engstrom@med.lu.se.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Engström
authors.affiliation: Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, CRC, Jan Waldenströms gata 35, Skane University Hospital, Malmö, 205 02 Malmö, Sweden. Electronic address: bo.hedblad@med.lu.se.
authors.forename: Bo
authors.initials: B
authors.lastname: Hedblad
mesh_terms: D050197:Atherosclerosis / Q000139:chemically induced*; D002104:Cadmium / Q000633:toxicity*; D002340:Carotid Artery Diseases / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013548:Sweden
chemical_list: D002104:Cadmium
keywords: Atherosclerosis; Cadmium; Cardiovascular risk factors; Carotid artery; Smoking