Gender-specific differences of interaction between cadmium exposure and obesity on prediabetes in the NHANES 2007-2012 population

Endocrine. 2018 Aug;61(2):258-266. doi: 10.1007/s12020-018-1623-3. Epub 2018 May 30.


Purpose: Data from National Health and Nutrition Examination Survey (NHANES) for the years 2007-2012 were used to evaluate the interactions of cadmium (Cd) exposure with being overweight/obesity on the risk of prediabetes among adults 20 years older.

Methods: A total of 3552 subjects were included in the analysis. Urinary cadmium levels (UCd) was used as a biomarker for long-term exposure to Cd. Additive interaction was estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S).

Results: Following covariates adjustments, we found significant associations of UCd with higher prediabetes prevalence, and this association was more apparent in males (Q4 vs Q1: OR = 1.95, 95%CI: 1.34-2.84); while overweight/obesity was associated with prediabetes both in males and in females. Additionally, there was a significant interaction between Cd exposure and being overweight/obesity on prediabetes risk among males (RERI = 1.18, 95% CI: 0.42-1.93; AP = 0.35, 95% CI: 0.12-0.58; S = 2.00, 95% CI: 0.92-4.34).

Conclusions: Our results suggest that being overweight/obesity may substantially amplify the adverse effects of long-term cadmium exposure on prediabetes risk, and this interaction is more severe in male adults. Further studies are needed to confirm these findings.

Keywords: Cadmium; Interaction; Obesity; Prediabetes.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Cadmium / toxicity
  • Cadmium / urine*
  • Cross-Sectional Studies
  • Environmental Exposure / adverse effects
  • Environmental Exposure / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Obesity / complications
  • Obesity / epidemiology*
  • Obesity / urine
  • Prediabetic State / complications
  • Prediabetic State / epidemiology*
  • Prediabetic State / urine
  • Prevalence
  • Sex Factors
  • Urinalysis
  • Young Adult


  • Cadmium