Objectives
Cadmium exposure's impact on adolescent liver health is of concern. This study aimed to explore the association between cadmium exposure and liver health in adolescents.
Methods
A cross-sectional study was conducted using data from NHANES 2017–2020.3. Urinary cadmium concentration was used as an indicator of exposure. Liver ultrasound parameters, controlled attenuation parameter (CAP) and stiffness (E) (STF), were employed to assess the degree of liver steatosis and fibrosis in adolescents. Multivariate linear and logistic regression analyses were performed to examine the correlations between cadmium exposure and liver health. Mediation analysis was utilized to explore the roles of alkaline phosphatase, creatine phosphokinase, cholesterol, triglycerides, C-reactive protein, and creatinine. Additionally, a restricted cubic spline (RCS) analysis was conducted to evaluate the impact of nutritional intake on liver health in high-cadmium exposure groups.
Results
Cadmium exposure levels were associated with ethnicity and family income. Regression analysis showed a negative correlation with CAP and a positive correlation with STF. Mediation analysis demonstrated that creatinine and triglycerides partially mediated cadmium's effect on CAP, while only creatinine mediated the effect on STF. Dietary intake, including eicosadienoic acid and theobromine, significantly impacts liver health in adolescents with high cadmium exposure.
Conclusions
Cadmium exposure affects liver health by inhibiting steatosis and promoting fibrosis, with renal and lipid metabolism factors acting as mediators, and diet influencing the outcomes.
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