Journal of Preventive Medicine and Public Health

Original Articles

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; DOI: https://doi.org/10.3961/jpmph.21.435

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Abstract Summary PDF Supplementary Material

Objectives
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.
Methods
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.
Results
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.
Conclusions
Chronic exposure to cadmium showed positive associations with liver damage.

Summary

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.

Citations

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Mercury Exposure in Association With Decrease of Liver Function in Adults: A Longitudinal Study: Jonghyuk Choi, Sanghyuk Bae, Hyungryul Lim, Ji-Ae Lim, Yong-Han Lee, Mina Ha, Ho-Jang Kwon; J Prev Med Public Health. 2017;50(6):377-385. Published online November 7, 2017; DOI: https://doi.org/10.3961/jpmph.17.099

25,585 View
229 Download
30 Crossref

Abstract PDF Supplementary Material

Objectives
Although mercury (Hg) exposure is known to be neurotoxic in humans, its effects on liver function have been less often reported. The aim of this study was to investigate whether total Hg exposure in Korean adults was associated with elevated serum levels of the liver enzymes aspartate aminotransferase (AST), alanine transaminase (ALT), and gamma-glutamyltransferase (GGT).
Methods
We repeatedly examined the levels of total Hg and liver enzymes in the blood of 508 adults during 2010-2011 and 2014-2015. Cross-sectional associations between levels of blood Hg and liver enzymes were analyzed using a generalized linear model, and nonlinear relationships were analyzed using a generalized additive mixed model. Generalized estimating equations were applied to examine longitudinal associations, considering the correlations of individuals measured repeatedly.
Results
GGT increased by 11.0% (95% confidence interval [CI], 4.5 to 18.0%) in women and 8.1% (95% CI, -0.5 to 17.4%) in men per doubling of Hg levels, but AST and ALT were not significantly associated with Hg in either men or women. In women who drank more than 2 or 3 times per week, AST, ALT, and GGT levels increased by 10.6% (95% CI, 4.2 to 17.5%), 7.7% (95% CI, 1.1 to 14.7%), and 37.5% (95% CI,15.2 to 64.3%) per doubling of Hg levels, respectively, showing an interaction between blood Hg levels and drinking.
Conclusions
Hg exposure was associated with an elevated serum concentration of GGT. Especially in women who were frequent drinkers, AST, ALT, and GGT showed a significant increase, with a significant synergistic effect of Hg and alcohol consumption.

Summary

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