Associations of cadmium exposure with risk of metabolic syndrome and its individual components: a meta-analysis

Data directly associating cadmium (Cd) with metabolic syndrome (MetS) are sparse and inconsistent. We aimed to quantitatively assess the association of Cd exposure with risk of MetS and its individual components. Literature searching was performed in PubMed, EMBASE, and MEDLINE-OVID through September, 2021. Weighted odds ratios (ORs) for MetS and its components were pooled by comparing the highest to the lowest category of Cd exposure using random-effects models. Eleven (10 from Asia and 1 from the US) cross-sectional studies (33,887 participants and 7176 cases) were identified. Overall, Cd exposure was not associated with risk of MetS [OR: 1.08, 95% confidence interval (CI): 0.92, 1.28]. However, the association became significant when pooling Asian studies (OR: 1.18, 95% CI: 1.02, 1.35), and it was more pronounced with Cd measured in blood (OR: 1.24, 95% CI: 1.05, 1.45). Additionally, Cd exposure was significantly associated with reduced HDL-cholesterol (OR: 1.27, 95% CI: 1.05, 1.54) and elevated triglyceride (OR: 1.17, 95% CI: 1.05, 1.30), but not other components. This meta-analysis indicates that Cd exposure is associated with risk of MetS among Asian populations, which is mainly explained by Cd’s association with dyslipidemia. Further studies are needed to better understand the mechanism of action.