title: Association of urinary cadmium with risk of diabetes: a meta-analysis.
abstract: The association between urinary cadmium and diabetes risk remains controversial. PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang Data updated on 21 June 2016 were searched for eligible publications. Pooled odds ratio (OR) with 95% confidence interval (CI) of diabetes for highest versus lowest level of urinary cadmium was calculated by using fixed-effect model or random-effect model. Dose-response relationship between urinary cadmium and diabetes was estimated by restricted cubic spline. A total of nine studies with 28,691 participants were included in this meta-analysis. The pooled OR of diabetes for the highest versus lowest level of urinary cadmium was 1.02 (95% CI, 1.00, 1.05; I2= 42.3%). In subgroup analysis, the ORs were 1.02 (95% CI 1.00, 1.05; I2= 0.9%) for studies conducted in Asia and 1.11 (95% CI 0.88, 1.41; I2= 86.3%) in America. For dose-response analysis, a linear relationship was found between urinary cadmium and the risk of diabetes (Pfor nonlinear= 0.5856). For every l μg/g creatinine increment of urinary cadmium, the risk of diabetes increased by 16% (1.16, 95% CI 1.08, 1.25). This meta-analysis suggests that cadmium exposure might be significantly associated with prevalence of diabetes, but large prospective studies are needed to confirm this finding.
authors.affiliation: Department of Epidemiology and Health Statistics, Qingdao University Medical College, No. 38 Deng Zhou Road, Qingdao, 266021, China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Social Medicine and Health Service Management, Affiliated Hospital of Qingdao University, Qingdao, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Health Statistics, Qingdao University Medical College, No. 38 Deng Zhou Road, Qingdao, 266021, China.
authors.forename: Weijing
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Health Statistics, Qingdao University Medical College, No. 38 Deng Zhou Road, Qingdao, 266021, China. yiliwu79@163.com.
authors.forename: Yili
authors.identifier: http://orcid.org/0000-0002-5289-2552
authors.initials: Y
authors.lastname: Wu
mesh_terms: D001208:Asia; D002104:Cadmium / Q000633:toxicity* / Q000652:urine; D002681:China; D003920:Diabetes Mellitus / Q000453:epidemiology*; D006801:Humans; D011446:Prospective Studies; D012306:Risk; D014481:United States
chemical_list: D002104:Cadmium
keywords: Diabetes; Dose-response analysis; Epidemiology; Heavy metal; Meta-analysis; Urinary cadmium