Abstract P249: Urinary Cadmium and Cardiovascular Health: Findings from the Survey of the Health of Wisconsin

Abstract

Mounting evidence in both human and animal studies suggest cadmium exposure increases the risk for cardiovascular disease morbidity and mortality. Recent evidence have found associations between cadmium exposures and mortality in the general US population, however, studies of incident CVD events have been mixed. Consequently, there is a need to better understand determinants of variations in cadmium exposure and the association of current population exposure levels with cardiovascular risk factors in diverse population-based studies. Data from a sub-sample of 300 participants from the 2008-11 waves of the Survey of the Health of Wisconsin (SHOW) were used to study the association between urinary cadmium levels and cardiovascular health. SHOW is based on a probabilistic statewide sample of adult (21-74 years old) residents of the state of Wisconsin. Good cardiovascular health (CVH) was defined as recommended by the American Heart Association, using a combination of “ideal or intermediate” levels of seven factors and health behaviors (body mass index, cholesterol, glucose, diet, physical activity, blood pressure and smoking). Associations of log-linear estimates of creatinine-adjusted cadmium levels (ug/g creatinine) and CVH were examined using logistic and linear regression models. Covariates included individual-level demographics (race/ethnicity and gender), SES (median family income and education), smoking status (current or former vs. non), and diet (fruits and vegetable consumption). Urinary cadmium levels (ug/g creatine) were statistically higher than comparable national estimates among women (geometric mean = .36;95% CI =.30-.44) and populations living 200% above federal poverty estimates (geometric mean =.32; 95% CI .28-.38). Higher cadmium levels were associated with good CVH (OR 1.4; 1.06-1.90). Using linear regression log-cadmium levels were inversely associated with BMI (ß=-1.04; p-value=.002) after adjustment for sociodemographic, smoking and dietary factors. Stratified analyses found associations held among non-smokers but not current or former. Cadmium was not associated with any other individual CVH factors. Paradoxically, findings suggest that urinary cadmium levels, a marker of chronic cadmium exposure, are associated with high SES, lower levels of BMI and good cardiovascular health in this population based sample, further exploration and long-term follow-up are warranted.