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Cadmium and lead exposure and risk of cataract surgery in U.S. adults.
Int J Hyg Environ Health 2016; 219(8):850-856IJ

Abstract

Cataract is a major cause of visual dysfunction and the leading cause of blindness. Elevated levels of cadmium and lead have been found in the lenses of cataract patients, suggesting these metals may play a role in cataract risk. This study aimed to examine the associations of blood lead, blood cadmium and urinary cadmium with cataract risk. We identified 9763 individuals aged 50 years and older with blood lead and cadmium levels, and a randomly selected subgroup of 3175 individuals with available urinary cadmium levels, from the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2008 (mean age=63years). Participants were considered to have cataract if they self-reported prior cataract surgery in NHANES's vision examination. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using survey logistic regression models. We identified 1737 cataract surgery cases (the weighted prevalence=14.1%). With adjustment for age, race/ethnicity, gender, education, diabetes mellitus, body mass index, cigarette smoking (serum cotinine and pack-years) and urine hydration, every 2-fold increase in urinary cadmium was associated with a 23% higher risk of cataract surgery (OR=1.23, 95% CI: 1.04, 1.46, p=0.021). We found no associations of cataract surgery with blood cadmium (OR=0.97, 95% CI: 0.89, 1.07) and blood lead (OR=0.97, 95% CI: 0.88, 1.06). Mediation analysis showed that for the smoking-cadmium-cataract pathway, the ratio of smoking's indirect effect to the total effect through cadmium was more than 50%. These results suggest that cumulative cadmium exposure may be an important under-recognized risk factor for cataract. However, these findings should be interpreted with a caution because of inconsistent results between urinary cadmium and blood cadmium.

Authors+Show Affiliations

Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA. Electronic address: weiyew@umich.edu.Department of Ophthalmology & Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT 84132, USA; Global Medical Affairs, Shire, Lexington, MA 02421, USA. Electronic address: dschaumberg0@shire.com.Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA; Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA. Electronic address: sungkyun@umich.edu.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

27460785

Citation

Wang, Weiye, et al. "Cadmium and Lead Exposure and Risk of Cataract Surgery in U.S. Adults." International Journal of Hygiene and Environmental Health, vol. 219, no. 8, 2016, pp. 850-856.
Wang W, Schaumberg DA, Park SK. Cadmium and lead exposure and risk of cataract surgery in U.S. adults. Int J Hyg Environ Health. 2016;219(8):850-856.
Wang, W., Schaumberg, D. A., & Park, S. K. (2016). Cadmium and lead exposure and risk of cataract surgery in U.S. adults. International Journal of Hygiene and Environmental Health, 219(8), pp. 850-856. doi:10.1016/j.ijheh.2016.07.012.
Wang W, Schaumberg DA, Park SK. Cadmium and Lead Exposure and Risk of Cataract Surgery in U.S. Adults. Int J Hyg Environ Health. 2016;219(8):850-856. PubMed PMID: 27460785.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cadmium and lead exposure and risk of cataract surgery in U.S. adults. AU - Wang,Weiye, AU - Schaumberg,Debra A, AU - Park,Sung Kyun, Y1 - 2016/07/19/ PY - 2016/05/27/received PY - 2016/07/14/accepted PY - 2016/10/31/pubmed PY - 2017/8/2/medline PY - 2016/7/28/entrez KW - Cadmium KW - Cataract KW - Mediation analysis KW - NHANES KW - Smoking SP - 850 EP - 856 JF - International journal of hygiene and environmental health JO - Int J Hyg Environ Health VL - 219 IS - 8 N2 - Cataract is a major cause of visual dysfunction and the leading cause of blindness. Elevated levels of cadmium and lead have been found in the lenses of cataract patients, suggesting these metals may play a role in cataract risk. This study aimed to examine the associations of blood lead, blood cadmium and urinary cadmium with cataract risk. We identified 9763 individuals aged 50 years and older with blood lead and cadmium levels, and a randomly selected subgroup of 3175 individuals with available urinary cadmium levels, from the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2008 (mean age=63years). Participants were considered to have cataract if they self-reported prior cataract surgery in NHANES's vision examination. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using survey logistic regression models. We identified 1737 cataract surgery cases (the weighted prevalence=14.1%). With adjustment for age, race/ethnicity, gender, education, diabetes mellitus, body mass index, cigarette smoking (serum cotinine and pack-years) and urine hydration, every 2-fold increase in urinary cadmium was associated with a 23% higher risk of cataract surgery (OR=1.23, 95% CI: 1.04, 1.46, p=0.021). We found no associations of cataract surgery with blood cadmium (OR=0.97, 95% CI: 0.89, 1.07) and blood lead (OR=0.97, 95% CI: 0.88, 1.06). Mediation analysis showed that for the smoking-cadmium-cataract pathway, the ratio of smoking's indirect effect to the total effect through cadmium was more than 50%. These results suggest that cumulative cadmium exposure may be an important under-recognized risk factor for cataract. However, these findings should be interpreted with a caution because of inconsistent results between urinary cadmium and blood cadmium. SN - 1618-131X UR - https://www.unboundmedicine.com/medline/citation/27460785/Cadmium_and_lead_exposure_and_risk_of_cataract_surgery_in_U_S__adults_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1438-4639(16)30167-5 DB - PRIME DP - Unbound Medicine ER -