Urinary cadmium was linearly and positively associated with cardiac infarction/injury score and subclinical myocardial injury in the general population without cardiovascular diseases and chronic kidney disease

Purpose The study was to investigate the association between urinary cadmium with cardiac infarction/injury score (CIIS) and subclinical myocardial injury (SC-MI) in the general population without cardiovascular diseases (CVDs) and chronic kidney disease (CKD). Methods In this large-scale cross-sectional study, we enrolled 4492 individuals without CVDs and CKD from the third National Health and Nutrition Examination Survey. Logistic regression models, linear regression models, subgroup analyses, and restricted cubic spline (RCS) were performed to assess the association between urinary cadmium with CIIS and SC-MI. Results Participants with SC-MI had higher levels of urinary cadmium compared with those without SC-MI ( P < 0.001). In multivariate regression analyses adjusting for all confounding variables, higher levels of urinary cadmium were strongly associated not only with higher risk of SC-MI but also with higher CIIS ( P < 0.05). Further subgroup analyses showed that the association between urinary cadmium and SC-MI remained significant in the subgroups of ≥ 50 years, men, smokers, and those without diabetes or hypertension ( P < 0.05). Additionally, RCS analysis showed that after adjusting for all confounding factors, urinary cadmium was linearly and positively associated with CIIS and SC-MI ( P overall < 0.05, P for nonlinearity > 0.05). Conclusion Urinary cadmium was linearly and positively associated with CIIS and SC-MI in the general population without CVDs and CKD.