Association of blood cadmium levels with all-cause and cause-specific mortality among adults with non-alcoholic fatty liver disease

A prospective cohort study

Datos Bibliográficos

ID22073137
AutoresCongxi Xu (Hebei Medical University), Zhi Li (0000-0002-6039-1045, Hebei Medical University), Shirui Hao (0000-0002-2560-0550, Hebei Medical University), Jian Zhang (0000-0001-7681-8747, Hebei Medical University), Jinlong Li (0000-0003-2279-9506), Jin‐Long Li (0000-0002-5133-9165, Hebei Medical University), Kuopeng Liang (Hebei Medical University), Xiaojuan Wang (0000-0003-0809-8594, Hebei Medical University), Yi Zhang (0000-0002-7581-7061, Hebei Medical University), Guangyuan Zhao (0000-0002-1095-8875, Hebei Medical University), Mengyun Bai (Hebei Medical University), Dengxiang Liu (0009-0001-7247-223X, Hebei Medical University, autor de correspondencia), Jitao Wang (0009-0001-2178-1171, Beijing Tsinghua Chang Gung Hospital, autor de correspondencia)
Año2025
Volumen13
Páginas1573760-1573760
Fecha de publicación2025-04-04
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaFrontiers in Public Health (JOURNAL)
Identificadores de la revistaISSN: 2296-2565 • E-ISSN: 2296-2565
EditorialFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1573760
PMID40255375
OpenAlexW4409166762
IdiomaEN
Referencias citadas50

Background: Cadmium (Cd) accumulates in the body over time, damaging organs such as the liver, kidneys, and brain. Some researchers have suggested that elevated blood Cd levels may contribute to the onset and progression of nonalcoholic fatty liver disease (NAFLD). However, only a few studies have explored the relationship between Cd exposure and long-term health outcomes in patients with NAFLD. This study aimed to evaluate the predictive value of blood cadmium levels for mortality risk in patients with NAFLD. Methods: This study analyzed data from 13,450 patients with NAFLD in the National Health and Nutrition Examination Survey (NHANES) database, covering the years 1999 to 2018. Patients were categorized into three groups based on their blood Cd levels. The relationship between blood cadmium concentrations and all-cause, cardiovascular, and cancer mortality in NAFLD patients was assessed using Cox proportional hazards regression while accounting for potential confounders. Results were visualized using Kaplan-Meier and restricted cubic spline (RCS) curves. Stratified analyses were performed for validation of the robustness of the results. Results: After adjusting for all covariates, blood Cd levels were positively associated with all-cause, cardiovascular, and cancer mortality in patients with NAFLD, showing a significant linear dose-response relationship. Specifically, for each unit increase in Log-transformed blood cadmium concentration, the risk of all-cause mortality increased by 191% (HR = 2.91, 95% CI: 2.39-3.53); cardiovascular mortality risk increased by 160% (HR = 2.6, 95% CI: 1.80-3.76); and cancer mortality risk increased by 279% (HR = 3.79, 95% CI: 2.54-5.65). Stratified analysis confirmed the robustness of these findings. Conclusion: Our study suggests that high Blood Cd levels adversely affect the prognosis of patients with NAFLD. Individuals with NAFLD should be aware of Cd exposure and take preventive measures. Moreover, stricter environmental protection policies may be necessary to reduce Cd exposure

Cause of death · Cohort study · Confounding · Disease · Environmental health · Fatty liver · National Health and Nutrition Examination Survey · Nonalcoholic fatty liver disease · Population · Proportional hazards model · Prospective cohort study · Heavy Metal Exposure and Toxicity · Heavy metals in environment · Medicine · Trace Elements in Health · Gastroenterology · Internal Medicine