Oxidative stress and inflammation mediate the adverse effects of cadmium exposure on all-cause and cause-specific mortality in patients with diabetes and prediabetes
Authors' conclusion
Cadmium exposure increases the risk of all-cause, CVD, and cancer mortality in patients with diabetes and prediabetes. Oxidative stress and inflammation appear to partially mediate this adverse effect. These findings emphasize the urgent need for targeted interventions to reduce cadmium-related mortality risks.
Study context
- Population
- Adults with diabetes and prediabetes, National Health and Nutrition Examination Survey (NHANES) 1999–2018
- Participants
- 17,687 adults
- Exposure
- Highest vs lowest quartile of blood cadmium
- Outcome
- All-cause, CVD and cancer mortality
Main finding
As reported in the abstract
All-cause, CVD and cancer mortality (161,047.75 person-years; 3562 deaths, 1214 CVD, 680 cancer)
Highest quartile vs Lowest quartileEstimate (95% CI)
Fully adjusted
HR (all-cause mortality) 2.17(1.69–2.79)
All-cause, CVD and cancer mortality (161,047.75 person-years; 3562 deaths, 1214 CVD, 680 cancer)
HR (CVD mortality) 2.06(1.41–3.02)
All-cause, CVD and cancer mortality (161,047.75 person-years; 3562 deaths, 1214 CVD, 680 cancer)
HR (cancer mortality) 2.38(1.47–3.85)
Observational data: associations, not effects.
Further findings
Mediation by oxidative stress and inflammation biomarkers
- UA, NLR, MLR, NMLR and SIRI partially mediated associations of cadmium with all-cause and cardiovascular disease (CVD) mortality; mediated proportions
- 1.4 to 4.8%
- GGT mediated a small fraction of associations with all-cause and cancer mortality
Original publication
Oxidative stress and inflammation mediate the adverse effects of cadmium exposure on all-cause and cause-specific mortality in patients with diabetes and prediabetes. Cardiovasc Diabetol. Published 29 March 2025. doi:10.
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