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Associations of cadmium exposure with risk of metabolic syndrome and its individual components: a meta-analysis

Journal of Exposure Science & Environmental Epidemiology (2022)Cite this article

Abstract

Data directly associating cadmium (Cd) with metabolic syndrome (MetS) are sparse and inconsistent. We aimed to quantitatively assess the association of Cd exposure with risk of MetS and its individual components. Literature searching was performed in PubMed, EMBASE, and MEDLINE-OVID through September, 2021. Weighted odds ratios (ORs) for MetS and its components were pooled by comparing the highest to the lowest category of Cd exposure using random-effects models. Eleven (10 from Asia and 1 from the US) cross-sectional studies (33,887 participants and 7176 cases) were identified. Overall, Cd exposure was not associated with risk of MetS [OR: 1.08, 95% confidence interval (CI): 0.92, 1.28]. However, the association became significant when pooling Asian studies (OR: 1.18, 95% CI: 1.02, 1.35), and it was more pronounced with Cd measured in blood (OR: 1.24, 95% CI: 1.05, 1.45). Additionally, Cd exposure was significantly associated with reduced HDL-cholesterol (OR: 1.27, 95% CI: 1.05, 1.54) and elevated triglyceride (OR: 1.17, 95% CI: 1.05, 1.30), but not other components. This meta-analysis indicates that Cd exposure is associated with risk of MetS among Asian populations, which is mainly explained by Cd’s association with dyslipidemia. Further studies are needed to better understand the mechanism of action.

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Fig. 1
Fig. 2: Weighted ORs (95% CIs) of MetS comparing the highest to the lowest Cd exposure category in 12 independent cohorts from 11 cross-sectional studies.
Fig. 3: Weighted ORs (95% CIs) of MetS comparing the highest to the lowest Cd exposure category in Asian studies.
Fig. 4: Weighted ORs (95% CIs) of individual MetS components comparing the highest to the lowest Cd exposure category in 7 cross-sectional studies.

Data availability

All the STATA codes for performing the analyses and generating the figures will be made available upon request pending from the corresponding author.

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Author contributions

LL was responsible for conducting the research, screening potentially eligible studies, extracting and analyzing data, quality assessment, interpreting results, updating reference lists, creating tables and figures, and writing original draft preparation. YL was responsible for conducting the research, screening potentially eligible studies, extracting and analyzing data, quality assessment, interpreting results, writing review, and revising the manuscript. CC was responsible for quality assessment, interpreting results, writing review, and revising the manuscript. YZ was responsible for creating tables and figures, writing review, and revising the manuscript. WG was responsible for writing review and revising the manuscript. SZ was responsible for writing review and revising the manuscript. KK was responsible for conceptualization, supervision, writing review, and revising the manuscript.

Funding

This study was partially supported by the grants from the National Institutes of Health (R01DK116603 and RF1AG056111).

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Author notes

  1. These authors contributed equally: Liping Lu, Yuexia Li.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA

    Liping Lu, Cheng Chen, Yijia Zhang & Ka Kahe

  2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA

    Liping Lu, Cheng Chen, Yijia Zhang & Ka Kahe

  3. Department of Intensive Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China

    Yuexia Li

  4. Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China

    Yuexia Li, Wenzhi Guo & Shuijun Zhang

  5. Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China

    Wenzhi Guo & Shuijun Zhang

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  1. Liping Lu
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Lu, L., Li, Y., Chen, C. et al. Associations of cadmium exposure with risk of metabolic syndrome and its individual components: a meta-analysis. J Expo Sci Environ Epidemiol (2022). https://doi.org/10.1038/s41370-022-00444-7

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  • DOI: https://doi.org/10.1038/s41370-022-00444-7

Keywords

  • Cadmium
  • Metabolic syndrome
  • Asian
  • Lipid metabolism
  • Biomarker
  • Meta-analysis

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