Association between blood cadmium level and age-related macular degeneration in a representative Korean population

To investigate the association between blood cadmium level and AMD.

This population-based, cross-sectional study using a nationwide, systemically stratified, multistage, clustered sampling method included 4933 subjects older than 40 years who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) between 2008 and 2012 and had fundus photographs taken. All participants underwent a standardized interview, evaluation of blood cadmium concentrations, and comprehensive ophthalmic examination. A 45° digital fundus photograph was taken from both eyes under physiologic mydriasis, and were graded using the international classification and grading system for AMD.

Mean blood cadmium levels were 1.47 μg/L in women and 1.19 μg/L in men. After adjusting for potential confounders, including age, sex, and smoking status, the odds ratio (OR) for AMD was significantly increased in the highest quintile blood cadmium group (OR, 1.96; 95% confidence interval [CI], 1.17-3.29; P for trend = 0.017). This association between blood cadmium level and AMD was significant in men (OR, 2.11; 95% CI, 1.11-4.02; P for trend = 0.024), but not in women (OR, 1.29; 95% CI, 0.70-2.52; P for trend = 0.158).

This study provides the first epidemiologic evidence that higher blood cadmium level is associated with AMD. Results of the present study indicate that an elevated cadmium burden may increase the risk of AMD development.