The association of cadmium and lead exposures with red cell distribution width.

Autor: Peters JL; Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, United States of America., Perry MJ; Department of Environmental and Occupational Health, George Washington University, Washington, District of Columbia, United States of America., McNeely E; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America., Wright RO; Icahn School of Medicine, Mount Sinai Hospital, New York, New York, United States of America., Heiger-Bernays W; Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, United States of America., Weuve J; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2021 Jan 11; Vol. 16 (1), pp. e0245173. Date of Electronic Publication: 2021 Jan 11 (Print Publication: 2021).
DOI: 10.1371/journal.pone.0245173
Abstrakt: Elevated red blood cell distribution width (RDW), traditionally an indicator of anemia, has now been recognized as a risk marker for cardiovascular disease incidence and mortality. Experimental and acute exposure studies suggest that cadmium and lead individually affect red blood cell production; however, associations between environmental exposures and RDW have not been explored. We evaluated relationships of environmental cadmium and lead exposures to RDW. We used data from 24,607 participants aged ≥20 years in the National Health and Nutrition Examination Survey (2003-2016) with information on blood concentrations of cadmium and lead, RDW and socio-demographic factors. In models adjusted for age, sex, race/ethnicity, education, poverty income ratio, BMI, alcohol consumption, smoking status and serum cotinine, RDW was increasingly elevated across progressively higher quartiles of blood cadmium concentration. A doubling of cadmium concentration was associated with 0.16 higher RDW (95% CI: 0.14, 0.18) and a doubling of lead concentration with 0.04 higher RDW (95% CI: 0.01, 0.06). Also, higher cadmium and lead concentrations were associated with increased odds of high RDW (RDW>14.8%). The associations were more pronounced in women and those with low-to-normal mean corpuscular volume (MCV) and held even after controlling for iron, folate or vitamin B12 deficiencies. In analysis including both metals, cadmium remained associated with RDW, whereas the corresponding association for lead was substantially attenuated. In this general population sample, blood cadmium and lead exposures were positively associated with RDW. The associations may indicate hemolytic or erythropoietic mechanisms by which exposure increases mortality risk.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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