Journals Information
Universal Journal of Public Health Vol. 13(5), pp. 1290 - 1302
DOI: 10.13189/ujph.2025.130521
Reprint (PDF) (865Kb)
Chronic Low-Dose Cadmium Exposure and Its Nonlinear Association with Hypertension and Obesity in Urban Chinese Adults: A Stratified Epidemiological Analysis
Haoxuan Feng 1, Siti Ruzita Mahmod 1,*, Rania Hussien Al-Ashwal 1,2
1 Department of Biomedical Engineering and Health Sciences, Faculty of Electrical Engineering, Universiti Teknologi Malaysia, Malaysia
2 Advanced Diagnostic and Progressive Human Care Research Group, Johor Bahru, Malaysia
ABSTRACT
This research explores the association between chronic exposure to low levels of cadmium (Cd) and the risk of developing hypertension and obesity among Chinese adults residing in urban environments. It focuses on both non-linear dose-related effects and demographic susceptibilities that may influence health outcomes. A total of 1,200 adults were recruited from three cities in Shandong Province, a region experiencing rapid industrialization and urban expansion. Participants were selected using a stratified random sampling technique to ensure a representative sample. Urinary cadmium concentrations were measured using inductively coupled plasma mass spectrometry (ICP-MS), a highly sensitive and accurate analytical method. Standardized clinical definitions were applied to diagnose hypertension and obesity. To assess potential linear and non-linear relationships, as well as the modifying effects of sex and body mass index (BMI), the analysis employed logistic regression models, gender-stratified evaluations, and restricted cubic spline (RCS) modelling. The results revealed a significant association between urinary cadmium levels and elevated blood pressure, with the relationship appearing stronger in men, where the odds ratio (OR) was 3.494, compared to women, who exhibited an OR of 2.190. The influence of BMI on hypertension remained stable and independent across all statistical models. Furthermore, RCS analysis demonstrated a non-linear pattern in the relationship between cadmium exposure and the risk of hypertension. Specifically, the risk increased sharply at low to moderate cadmium concentrations and then plateaued at higher exposure levels. This non-linear trend challenges the assumptions of traditional linear threshold models and underscores the importance of using flexible analytical approaches in environmental health research. The findings support the view that cadmium is a vascular toxicant even at relatively low levels of environmental exposure. Moreover, demographic characteristics such as gender and obesity appear to modify individual vulnerability. This study contributes novel insights into how environmental pollutants affect cardiometabolic health in urban populations. It highlights the need for more targeted public health strategies, improved environmental monitoring, stricter regulation of cadmium emissions, and gender-responsive health education programs. Although the cross-sectional design limits causal interpretation, the findings provide a strong basis for future longitudinal investigations.
KEYWORDS
Cadmium Exposure, Hypertension, Stratified Analysis, Dose鈥揜esponse Relationship, Urban China
Cite This Paper in IEEE or APA Citation Styles
(a). IEEE Format:
[1] Haoxuan Feng , Siti Ruzita Mahmod , Rania Hussien Al-Ashwal , "Chronic Low-Dose Cadmium Exposure and Its Nonlinear Association with Hypertension and Obesity in Urban Chinese Adults: A Stratified Epidemiological Analysis," Universal Journal of Public Health, Vol. 13, No. 5, pp. 1290 - 1302, 2025. DOI: 10.13189/ujph.2025.130521.
(b). APA Format:
Haoxuan Feng , Siti Ruzita Mahmod , Rania Hussien Al-Ashwal (2025). Chronic Low-Dose Cadmium Exposure and Its Nonlinear Association with Hypertension and Obesity in Urban Chinese Adults: A Stratified Epidemiological Analysis. Universal Journal of Public Health, 13(5), 1290 - 1302. DOI: 10.13189/ujph.2025.130521.