Abstract
BACKGROUND AND AIM: In recent studies for the association between blood Cd and iron deficiency (ID), it was found that ID elevates blood cadmium levels in children, adolescents or adults. But, the previous studies almost only used either serum ferritin or Hemoglobin (Hb) for evaluating ID or iron deficiency anemia (IDA). Blood Cd level according to actual iron status have not been studied. The objective of this study was to investigate the association between Cd and Iron status(normal, negative iron balance, iron deficiency erythropoiesis, IDA) and the risk for high cadmium level depending each iron status using a large-scale nationwide representative sample of the Korean. METHODS: A nationwide cross-sectional study was conducted to examine the relationship between iron status and blood Cd level in 3,366 men and 3,443 women over 10 years of age, using data from the 2010–2012 Korean National Health and Nutrition Examination Survey (KNHANES). We used analysis of variance (ANOVA) or chi-square test to estimate differences in the demographic and biochemical characteristics of participants. Multiple logistic regression models were also used to examine the associations between iron status and high blood Cd level (75th percentile of Cd level in the current sample; 1.37μg/L) RESULTS:Mean values of blood Cd gradually increased in accordance with poor iron status (P-trend0.001). We found that increased risk for high Cd level was associated with poor iron status after adjusting for age, sex, BMI, education, income, cigarette smoking and alcohol consumption. In a sex and menopause stratified analysis, a significant association was stronger only in premenopause women, not in men, menopause women CONCLUSIONS:We found a relationship between poor iron status and blood Cd in a representative population sample of Korean adult. Our results suggested considering the reproductive toxicity of Cd, management for blood Cd level would be necessary in women of childbearing age with poor iron status KEYWORDS: Heavy metals, Environmental epidemiology
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