Table 2.
Pooled Estimated Relative Risk and 95 % confidence interval
| CVD | CHD | Stroke | PAD | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
| ||||||||||||
| No. Studies | RR (95 % CI) | I2 (p-value) | No. Studies | RR (95 % CI) | I2 (p-value) | No. Studies | RR (95 % CI) | I2 (p-value) | No. Studies | RR (95 % CI) | I2 (p-value) | |
| Study design | ||||||||||||
| Prospective | 5 [26–28••, 29••, 52••] | 1.23 (1.05, 1.44) | 42.8 (0.14) | 4 [26–28••, 29••] | 1.21 (1.07, 1.37) | 3.7 (0.37) | 3 [26, 29••, 52••] | 1.41 (0.57, 3.50) | 85.7 (0.001) | 2 [30••, 31••] | 1.63 (1.00, 2.66) | 39.3 (0.06) |
| Cross-sectional | 1 [59] | NA | NA | 3 [58, 60•, 63•] | 1.56 (1.00, 2.45) | 83.4 (0.02) | 2 [60•, 63•] | 1.10 (1.01, 1.20) | 0.0 (1.00) | 1 [62•] | NA | NA |
| Biomarker | ||||||||||||
| Blood cadmium | 3 [26, 28••, 59] | 1.41 (1.18, 1.70) | 0.0 (0.57) | 4 [26, 28••, 60•, 63•] | 1.41 (1.19, 1.68) | 18.4 (0.30) | 3 [26, 60•, 63•] | 1.19 (0.93, 1.52) | 42.5 (0.18) | 2 [29••, 30••] | 1.83 (1.33, 2.53) | 0.0 (0.56) |
| Urine cadmium | 6 [26–28••, 29••, 52••, 59] | 1.36 (1.11, 1.66) | 65.0 (0.01) | 6 [26–28••, 29••, 58, 60•] | 1.23 (1.07, 1.40) | 50.4 (0.07) | 4 [26, 29••, 52••, 60•] | 1.22 (0.78, 1.91) | 79.3 (0.002) | 3 [30••, 31••, 62•] | 1.49 (1.15, 1.92) | 0.0 (0.44) |
| Sex | ||||||||||||
| Men | 3 [27, 28••, 29••] | 1.29 (1.12, 1.48) | 35.3 (0.21) | 4 [27, 29••, 58, 63•] | 1.30 (0.97, 1.74) | 27.4 (0.25) | 3 [29••, 60•, 63•] | 1.37 (1.07, 1.75) | 0.0 (0.52) | 2 [31••, 62•] | 2.06 (0.82, 5.17) | 84.9 (0.01) |
| Women | 4 [27, 28••, 29••, 52••] | 1.20 (0.92, 1.56) | 80.5 (0.002) | 4 [27, 29••, 58, 63•] | 1.26 (0.75, 2.12) | 81.4 (0.001) | 4 [29••, 52••, 60•, 63•] | 1.39 (1.06, 1.82) | 25.8 (0.26) | 3 [30••, 31••, 62•] | 1.29 (0.67, 2.46) | 73.4 (0.02) |
| Never smokers | 4 [27, 28••, 29••, 52••] | 1.27 (0.97, 1.67) | 45.7 (0.14) | 2 [29••, 58] | 1.37 (0.88, 2.12) | 63.0 (0.10) | 3 [29••, 52••, 60•] | 1.17 (0.74, 1.87) | 53.7 (0.11) | 2 [31••, 62•] | 1.21 (0.83, 1.75) | 0.0 (0.56) |
| Overall a | 6 [26–28••, 29••, 52••, 59] | 1.36 (1.11, 1.66) | 65.0 (0.01) | 7 [26–28••, 29••, 58, 60•, 63•] | 1.30 (1.12, 1.52) | 61.4 (0.02) | 5 [26, 29••, 52••, 60•, 63•] | 1.18 (0.86, 1.59) | 72.5 (0.006) | 3 [30••, 31••, 62•] | 1.49 (1.15, 1.92) | 0.0 (0.44) |
CI, confidence interval, CVD, cardiovascular disease; CHD, coronary heart disease; PAD, peripheral arterial disease; RR, relative risk; NA, not available
a
For the overall we kept only one result for one specimen (urine preferred) but for the individual biomarker pooling we used the biomarker if available even if not included in the overall