Can we deduce the risk of developing AMD from the levels of Cadmium in the blood or urine? Is there any data that will help us understand this risk, if any?
First, let's understand about Cadmium (Cd). It is a naturally occurring, highly toxic, metallic element. It is supposed to have been a pollutant of the environment due to industrial activity and has been known to accumulate in human tissues with a long biological half-life. This accumulation, seen in retinal tissue as well, may damage the retina through oxidative stress.
Cd content has been demonstrated to increase in human retinal tissues as a function of age, while tobacco smokers, which is a key risk factor for AMD, have approximately twice as much cadmium in retinal tissues than non-smokers.
Age-related macular degeneration (AMD) is a complex disease resulting from the interplay of genetic predisposition and environmental exposures, and has been linked to oxidative stress and inflammatory mechanisms, which may point to the possibility of cadmium playing a role in the development of AMD.
Studies have shown that urinary cadmium levels (a measure of Cd body burden) are higher in smokers who have AMD . In a prospective study that was published in the American Journal of Ophthalmology in 2007, the authors tried to evaluate association between urinary and blood cadmium (Cd) levels to age-related macular degeneration (AMD). They found that current and former smokers with AMD had significantly higher median urine Cd/creatinine levels than nonsmokers with AMD or those without AMD. Blood Cd levels, indicative of short-term exposure levels, were not associated with AMD. They concluded that a higher urinary Cd level, which reflects the total body burden of Cd, was associated with AMD in smokers, which may be important in the development of smoking-related AMD.
In a study published in Experimental Eye Research in 2009, higher cadmium levels were found in the neural retina and RPE in eyes afflicted with AMD compared to age-matched controls in males. The differences were not found to be statistically significant in females. The results from this study indicated that higher retinal cadmium burdens are associated with the presence of AMD at least in males and suggested possible gender differences in the metabolism of metals in the human retina.
First, let's understand about Cadmium (Cd). It is a naturally occurring, highly toxic, metallic element. It is supposed to have been a pollutant of the environment due to industrial activity and has been known to accumulate in human tissues with a long biological half-life. This accumulation, seen in retinal tissue as well, may damage the retina through oxidative stress.
Cd content has been demonstrated to increase in human retinal tissues as a function of age, while tobacco smokers, which is a key risk factor for AMD, have approximately twice as much cadmium in retinal tissues than non-smokers.
Age-related macular degeneration (AMD) is a complex disease resulting from the interplay of genetic predisposition and environmental exposures, and has been linked to oxidative stress and inflammatory mechanisms, which may point to the possibility of cadmium playing a role in the development of AMD.
Studies have shown that urinary cadmium levels (a measure of Cd body burden) are higher in smokers who have AMD . In a prospective study that was published in the American Journal of Ophthalmology in 2007, the authors tried to evaluate association between urinary and blood cadmium (Cd) levels to age-related macular degeneration (AMD). They found that current and former smokers with AMD had significantly higher median urine Cd/creatinine levels than nonsmokers with AMD or those without AMD. Blood Cd levels, indicative of short-term exposure levels, were not associated with AMD. They concluded that a higher urinary Cd level, which reflects the total body burden of Cd, was associated with AMD in smokers, which may be important in the development of smoking-related AMD.
In a study published in Experimental Eye Research in 2009, higher cadmium levels were found in the neural retina and RPE in eyes afflicted with AMD compared to age-matched controls in males. The differences were not found to be statistically significant in females. The results from this study indicated that higher retinal cadmium burdens are associated with the presence of AMD at least in males and suggested possible gender differences in the metabolism of metals in the human retina.
A recent study published in Investigative Ophthalmology & Visual Science gives us more insight about the connection between blood cadmium level and AMD in Korea. The authors conducted a population-based, cross-sectional study that included 4933 subjects older than 40 years in the Korean National Health and Nutrition Examination Survey (KNHANES) between 2008 and 2012. The study found association between blood cadmium level and AMD was significant in men, but not in women, indicating that an elevated cadmium burden may increase the risk of AMD development.
So what does a patient with AMD do?
- Be aware of the likely possibility of an association between an elevated cadmium burden and risk of AMD, specially if you are a non-hispanic white male.
- If you are a smoker, please stop smoking, since you are increasing the risk of AMD in any case.
- Ask the health care professional you consult for your AMD about the risk related to Cadmium.
- If possible, you can request laboratory tests for cadmium burden, including blood and urine.
- There is no specific antidote for acute cadmium poisoning. Prevention of further exposure is the most important step in management. (see #3 below)
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