Table 3.
Hazard ratios (95% confidence interval) for incident cardiovascular endpoints by urine cadmium concentrations (n=3,348)
| Cadmium Quartiles (μg/g) | 80th vs 20th | |||||
|---|---|---|---|---|---|---|
| ≤ 0.61a HR (95% CI) | 0.62 – 0.92 HR (95% CI) | 0.93 – 1.45 HR (95% CI) | > 1.45 HR (95% CI) | percentile HR (95% CI) | Test for trendb | |
| Cardiovascular Disease | ||||||
| No. Cases / Non Cases: | (249 / 613) | (263 / 554) | (269 / 568) | (303 / 529) | (1084 / 2264) | |
| Model 1c | 1.00 | 1.17 (0.98–1.40) | 1.21 (1.01–1.46) | 1.34 (1.11–1.62) | 1.19 (1.07–1.31) | P= 0.001 |
| Model 2d | 1.00 | 1.26 (1.05–1.50) | 1.38 (1.14–1.66) | 1.58 (1.30–1.92) | 1.28 (1.16–1.42) | P <0.001 |
| Model 3e | 1.00 | 1.20 (1.00–1.44) | 1.30 (1.07–1.58) | 1.48 (1.21–1.80) | 1.24 (1.11–1.38) | P< 0.001 |
| Coronary Heart Disease | ||||||
| No. Cases / Non Cases | (193 / 669) | (182 / 635) | (198 / 639) | (193 / 639) | (766 / 2582) | |
| Model 1c | 1.00 | 1.09 (0.89–1.34) | 1.19 (0.96–1.47) | 1.18 (0.95–1.47) | 1.15 (1.02–1.30) | P =0.02 |
| Model 2d | 1.00 | 1.18 (0.96–1.45) | 1.38 (1.11–1.71) | 1.41 (1.12–1.78) | 1.26 (1.12–1.42) | P <0.001 |
| Model 3e | 1.00 | 1.13 (0.92–1.40) | 1.31 (1.05–1.63) | 1.33 (1.05–1.68) | 1.22 (1.08–1.38) | P =0.002 |
| Stroke | ||||||
| No. Cases / Non Cases | (51 / 811) | (51 / 766) | (53 / 784) | (89 / 743) | (244 / 3104) | |
| Model 1c | 1.00 | 1.14 (0.78–1.68) | 1.14 (0.77–1.68) | 1.91 (1.30–2.80) | 1.73 (1.22–2.45) | P =0.006 |
| Model 2d | 1.00 | 1.24 (0.84–1.84) | 1.22 (0.81–1.82) | 2.03 (1.35–3.06) | 1.82 (1.25–2.65) | P =0.006 |
| Model 3e | 1.00 | 1.21 (0.81–1.80) | 1.11 (0.73–1.69) | 1.87 (1.22–2.86) | 1.75 (1.17–2.59) | P =0.03 |
| Heart Failure | ||||||
| No. Cases / Non Cases | (60 / 802) | (81 / 736) | (87 / 750) | (100 / 732) | (328 / 3020) | |
| Model 1c | 1.00 | 1.35 (0.96–1.89) | 1.38 (0.98–1.95) | 1.41 (0.98–2.03) | 1.20 (0.88–1.63) | P =0.03 |
| Model 2d | 1.00 | 1.49 (1.06–2.11) | 1.65 (1.15–2.35) | 1.78 (1.22–2.59) | 1.46 (1.06–2.02) | P =0.002 |
| Model 3e | 1.00 | 1.40 (0.99–1.99) | 1.52 (1.06–2.18) | 1.61 (1.10–2.36) | 1.39 (1.01–1.94) | P =0.01 |
Reference category.
Models comparing the 80th (1.62 μg/g) to the 20th (0.55 μg/g) percentiles of urine cadmium distributions and associated test for trend were obtained from Cox proportional hazards models with log-transformed cadmium as a continuous variable, except for stroke and heart failure where cadmium was introduced as restricted quadratic splines with knots at percentiles 10th, 50th and 90th because of the non-linear relationships.
Model 1 adjusted for sex
Model 2 further adjusted for post-menopausal status for women (yes, no), education (< high school, ≥ high school), body mass index (kg/m2), total cholesterol (mg/dL), estimated LDL- cholesterol (mg/dL), hypertension (yes, no), diabetes (yes, no), and estimated glomerular filtration rate (ml/min/1.73m2).
Model 3 further adjusted for smoking status (never, former, current) and cumulative smoking dose (pack-years modeled as restricted cubic splines with knots at 10, 20 and 30 pack-years).