Parathyroid hormones in relation to serum cadmium and lead: the NHANES 2003-2006

The toxic effects of cadmium and lead exposure on parathyroid function have been investigated extensively while the results were conflicting. We aimed to investigate the association of blood cadmium and lead with serum parathyroid hormone (PTH) based on the general population. We analyzed a sample of 9400 adults aged 18 years or older from the US National Health and Nutrition Examination Survey 2003-2004 to 2005-2006. We estimated the association using multivariable linear regression analysis by taking cadmium and lead as a continuous or quartile variable. Restricted cubic splines were utilized to explore the non-linear relationship between cadmium or lead and PTH. The median blood cadmium and lead levels were 0.34 µg/L and 1.43 µg/dL, respectively. Cadmium was significantly associated with PTH when taken as a continuous variable [Odds ratio (OR): 0.97; 95% confidence interval (95% CI): 0.95-0.99] or a quartile variable (fourth vs first quartile, OR: 0.94; 95% CI: 0.91-0.97). Lead was significantly associated with PTH when taken as a continuous variable (OR: 1.04; 95% CI: 1.02-1.07) or a quartile variable (fourth vs first quartile, OR: 1.06; 95% CI: 1.01-1.10). P values for non-linearity were all less than 0.05. The association between cadmium and PTH was not significant in females. Cadmium was negatively associated with PTH, and lead was positively associated with PTH both in a non-linear manner among the general population. However, there was a gender difference in the relationship between cadmium and PTH.