Association Between Low-Level Blood Cadmium Exposure and Hyperuricemia in the American General Population: a Cross-sectional Study

Heavy metals, including cadmium, are suspected to increase serum uric acid levels and hyperuricemia in both gender, but the evidences about this are inconclusive. To determine whether serum cadmium in American adults(≥19 years old) is associated with uric acid levels and risk of hyperuricemia, 2620 participants from the US National Health and Nutrition Examination Survey were recruited. Hyperuricemia was defined as a serum UA concentration ≥ 416.4 μmol/L for men and ≥ 356.9 μmol/L for women. Regression analyses were used to analyze the association of cadmium with serum UA and hyperuricemia. The threshold effect explored using two-piecewise linear regression model by the smoothing plot. The overall median of blood cadmium was 0.27 μg/L in men and 0.33μg/L in women. After adjusting for the covariates (race; age; education; BMI; smoke status; alcohol consumption; blood lead; hypertension; diabetes mellitus; hemoglobin; eGFR; triglyceride; and cholesterol), a non-linear relationship between hyperuricemia and cadmium among men was detected; and there was a positive line correlation between them for women (OR = 1.58; 95%CI (1.08, 2.31)). No significant association between uric acid and cadmium in either gender was found. Blood cadmium levels in the range currently considered acceptable were positively associated with increased prevalence of hyperuricemia in women, but inversely associated in men (cadmium <0.77μg/L).