Association of urinary cadmium with risk of diabetes: a meta-analysis
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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; I 2 = 42.3%). In subgroup analysis, the ORs were 1.02 (95% CI 1.00, 1.05; I 2 = 0.9%) for studies conducted in Asia and 1.11 (95% CI 0.88, 1.41; I 2 = 86.3%) in America. For dose-response analysis, a linear relationship was found between urinary cadmium and the risk of diabetes (P for 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.
KeywordsUrinary cadmium Diabetes Epidemiology Heavy metal Dose-response analysis Meta-analysis
This work was supported by grants from the National Natural Science Foundation of China (81302485) and the Natural Science Foundation of Shandong Province (BS2013SF002).
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Conflict of interest
The authors declare that they have no conflict of interest.
- Harrell FE, Jr., Lee KL, Pollock BG (1988) Regression models in clinical studies: determining relationships between predictors and response. J Natl Cancer Inst 80:1198–202Google Scholar
- Lei LJ, Jin TY, Zhou YF (2007) Insulin expression in rats exposed to cadmium. Biomedical and environmental sciences: BES 20:295–301Google Scholar
- Son H-s et al (2015) Association of cadmium with diabetes in middle-aged residents of abandoned metal mines: the first health effect surveillance for residents in abandoned metal mines. Annals of occupational and environmental medicine:27. doi: 10.1186/s40557-015-0071-2
- Swaddiwudhipong W, Limpatanachote P, Nishijo M, Honda R, Mahasakpan P, Krintratun S (2010a) Cadmium-exposed population in Mae Sot district, Tak province: 3. Associations between urinary cadmium and renal dysfunction, hypertension, diabetes, and urinary stones. Journal of the Medical Association of Thailand = Chotmaihet thangphaet 93:231–238Google Scholar
- Swaddiwudhipong W, Mahasakpan P, Limpatanachote P, Krintratun S (2010b) Correlations of urinary cadmium with hypertension and diabetes in persons living in cadmium-contaminated villages in northwestern Thailand: a population study. Environ Res 110:612–616. doi: 10.1016/j.envres.2010.06.002 CrossRefGoogle Scholar
- Welinder H, Skerfving S, Henriksen O (1977) Cadmium metabolism in man. Br J Ind Med 34:221–228Google Scholar