Table 1.
Kidney, liver and pancreas as targets of toxicity to chronic exposure to low-dose cadmium.
| Targets | NHANES Dataset | Adverse Effects and Risk Estimate | References |
|---|---|---|---|
| Kidneys | 1999–2006 | Blood Cd levels >1 µg/L were associated with low GFR a (OR 1.48) and albuminuria b (OR 1.41). The OR for albuminuria was increased to 1.63 in those with urinary Cd ≥ 1 µg/g creatinine plus blood Cd > 1 µg/L. |
Ferraro et al. 2010 [29] |
| Kidneys | 1999–2006 | Blood Cd levels ≥ 0.6 μg/L were associated with low GFR (OR 1.32), albuminuria (OR 1.92) and low GFR plus albuminuria (OR 2.91). | Navas-Acien et al. 2009 [30] |
| Kidneys | 2011–2012 | Blood Cd levels ≥ 0.53 μg/L were associated albuminuria (OR 2.04) and low GFR (OR 2.21). | Lin et al. 2014 [31] |
| Kidneys | 2007–2012 | Blood Cd ≥ 0.61 μg/L were associated with low GFR (OR 1.80) and albuminuria (OR 1.60). | Madrigal et al. 2019 [32] |
| Liver | 1988–1994 | Urinary Cd levels ≥ 0.83 μg/g creatinine were associated with liver inflammation in women (OR 1.26). Urinary Cd ≥ 0.65 μg/g creatinine were associated with liver inflammation (OR 2.21), NAFLD (OR 1.30), and NASH (OR 1.95) in men. |
Hyder et al. 2013 [33] |
| Liver | 1999–2015 | A 10-fold increment of urinary Cd was associated with elevated plasma levels of total bilirubin (OR 1.20), ALT (OR 1.36), and AST (OR 1.31). | Hong et al. 2021 [34] |
| Liver | 1999–2016 | A urinary Cd quartile 4 was associated with elevated plasma ALT (OR 1.40) and AST (OR 1.64). The effect was larger in boys than in girls. | Xu et al. 2022 [35] |
| Pancreas | 1988–1994 | Urinary Cd levels 1–2 μg/g creatinine were associated prediabetes (OR 1.48) and diabetes (OR 1.24). |
Schwartz et al. 2003 [36] |
| Pancreas | 2005–2010 | Urinary Cd levels ≥ 1.4 µg/g creatinine were associated with pre-diabetes in non-smokers. In a fully adjusted model including smokers and non-smokers, urinary Cd levels between 0.7 and 0.9 µg/g creatinine were associated with pre-diabetic risk. | Wallia et al. 2014 [37] |
| Pancreas | 1999–2006 | Urinary Cd levels of 0.198 and 0.365 μg/g creatinine were identified as exposure levels at which the prevalence of type 2 diabetes was smaller than 5% and 10%, respectively. | Shi et al. 2021 [38] |
NHANES—National Health and Nutrition Examination Survey; a low GFR is defined as estimated glomerular filtration rate (eGFR) ≤ 60 mL/min/1.73 m2; b albuminuria is defined as urinary albumin-to-creatinine ratio ≥ 30 mg/g. OR—odds ratio; NAFLD—non-alcoholic fatty liver disease; NASH—non-alcoholic steatohepatitis.