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Dongui Hong 1 Article
Association Between Cadmium Exposure and Liver Function in Adults in the United States: A Cross-sectional Study
Dongui Hong, Jin-Young Min, Kyoung-Bok Min
J Prev Med Public Health. 2021;54(6):471-480.   Published online November 30, 2021
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AbstractAbstract AbstractSummary PDFSupplementary Material
Cadmium is widely used, leading to extensive environmental and occupational exposure. Unlike other organs, for which the harmful and carcinogenic effects of cadmium have been established, the hepatotoxicity of cadmium remains unclear. Some studies detected correlations between cadmium exposure and hepatotoxicity, but others concluded that they were not associated. Thus, we investigated the relationship between cadmium and liver damage in the general population.
In total, 11 838 adult participants from National Health and Nutrition Examination Survey 1999-2015 were included. Urinary cadmium levels and the following liver function parameters were measured: alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), total bilirubin (TB), and alkaline phosphatase (ALP). Linear and logistic regression analyses were performed to assess the associations between urinary cadmium concentrations and each liver function parameter after adjusting for age, sex, race/ethnicity, annual family income, smoking status, alcohol consumption status, physical activity, and body mass index.
The covariate-adjusted results of the linear regression analyses showed significant positive relationships between log-transformed urinary cadmium levels and each log-transformed liver function parameter, where beta±standard error of ALT, AST, GGT, TB, and ALP were 0.049±0.008 (p<0.001), 0.030±0.006 (p<0.001), 0.093±0.011 (p<0.001), 0.034±0.009 (p<0.001), and 0.040±0.005 (p<0.001), respectively. Logistic regression also revealed statistically significant results. The odds ratios (95% confidence intervals) of elevated ALT, AST, GGT, TB, and ALP per unit increase in log-transformed urinary cadmium concentration were 1.360 (1.210 to 1.528), 1.307 (1.149 to 1.486), 1.520 (1.357 to 1.704), 1.201 (1.003 to 1.438), and 1.568 (1.277 to 1.926), respectively.
Chronic exposure to cadmium showed positive associations with liver damage.
Korean summary
카드뮴은 사회 전반에서 널리 쓰이고 있어 직업적인 노출은 물론 환경적인 노출이 빈번히 일어나고 있다. 본 연구는 미국 국민건강영양조사 데이터를 이용하였으며 소변 내 카드뮴의 증가는 알라닌 아미노전이효소 (ALT), 아스파테이트 아미노전이효소 (AST), 감마 글루타밀전이효소 (GGT), 총 빌리루빈, 알칼리 인산분해효소 (ALP)의 상승과 관련이 있었다. 따라서 만성적인 카드뮴 노출은 간 손상과 연관이 있다고 할 수 있다.


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JPMPH : Journal of Preventive Medicine and Public Health