The relationship between body iron stores and blood and urine cadmium concentrations in US never-smoking, non-pregnant women aged 20–49 years

BackgroundCadmium is a ubiquitous environmental pollutant associated with increased risk of leading causes of mortality and morbidity in women, including breast cancer and osteoporosis. Iron deficiency increases absorption of dietary cadmium, rendering women, who tend to have lower iron stores than men, more susceptible to cadmium uptake. We used body iron, a measure that incorporates both serum ferritin and soluble transferrin receptor, as recommended by the World Health Organization, to evaluate the relationships between iron status and urine and blood cadmium.MethodsSerum ferritin, soluble transferrin receptor, urine and blood cadmium values in never-smoking, non-pregnant, non-lactating, non-menopausal women aged 20–49 years (n=599) were obtained from the 2003–2008 National Health and Nutrition Examination Surveys. Body iron was calculated from serum ferritin and soluble transferrin receptor, and iron deficiency defined as body iron <0 mg/kg. Robust linear regression was used to evaluate the relationships between body iron and blood and urine cadmium, adjusted for age, race, poverty, body mass index, and parity.ResultsPer incremental (mg/kg) increase in body iron, urine cadmium decreased by 0.003 μg/g creatinine and blood cadmium decreased by 0.014 μg/L. Iron deficiency was associated with 0.044 μg/g creatinine greater urine cadmium (95% CI=0.020, 0.069) and 0.162 μg/L greater blood cadmium (95% CI=0.132, 0.193).ConclusionsIron deficiency is a risk factor for increased blood and urine cadmium among never-smoking, pre-menopausal, non-pregnant US women, independent of age, race, poverty, body mass index and parity. Expanding programs to detect and correct iron deficiency among non-pregnant women merits consideration as a potential means to reduce the risk of cadmium associated diseases.

► Body iron was calculated from serum ferritin and soluble transferrin receptor.
► Body iron was inversely associated with blood and urine cadmium in US women.
► Inverse associations with blood cadmium were evident in all race/ethnic subsamples.
► Inverse associations with urine cadmium were evident in women of other/multi-race.
► Black women had lower mean body iron compared to white women.