{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:00:11Z","timestamp":1780491611001,"version":"3.54.1"},"reference-count":55,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Environmental exposure to cadmium (Cd) or lead (Pb) is independently associated with increased risks of type 2 diabetes, and chronic kidney disease. The aim of this study was to examine the effects of concurrent exposure to these toxic metals on the risks of diabetes and kidney functional impairment. The Cd and Pb exposure levels among study subjects were low to moderate, evident from the means for blood concentrations of Cd and Pb ([Cd]b and [Pb]b) of 0.59 \u00b5g\/L and 4.67 \u00b5g\/dL, respectively. Of 176 study subjects (mean age 60), 71 (40.3%) had abnormally high fasting plasma glucose levels. Based on their [Cd]b and [Pb]b, 53, 71, and 52 subjects were assigned to Cd and Pb exposure profiles 1, 2, and 3, respectively. The diagnosis of diabetes was increased by 4.2-fold in those with an exposure profile 3 (p = 0.002), and by 2.9-fold in those with the estimated glomerular filtration (eGFR) \u2264 60 mL\/min\/1.73 m2 (p = 0.029). The prevalence odds ratio (POR) for albuminuria was increased by 5-fold in those with plasma glucose levels above kidney threshold of 180 mg\/dL (p = 0.014), and by 3.1-fold in those with low eGFR) (p = 0.050). Collectively, these findings suggest that the Cd and Pb exposure profiles equally impact kidney function and diabetes risk.<\/jats:p>","DOI":"10.3390\/ijerph19042259","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T20:26:41Z","timestamp":1645043201000},"page":"2259","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Effects of Environmental Exposure to Cadmium and Lead on the Risks of Diabetes and Kidney Dysfunction"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1638-4227","authenticated-orcid":false,"given":"Supabhorn","family":"Yimthiang","sequence":"first","affiliation":[{"name":"Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phisit","family":"Pouyfung","sequence":"additional","affiliation":[{"name":"Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8277-4645","authenticated-orcid":false,"given":"Tanaporn","family":"Khamphaya","sequence":"additional","affiliation":[{"name":"Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0631-9058","authenticated-orcid":false,"given":"Saruda","family":"Kuraeiad","sequence":"additional","affiliation":[{"name":"Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paleeratana","family":"Wongrith","sequence":"additional","affiliation":[{"name":"Community Public Health, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2856-6650","authenticated-orcid":false,"given":"David A.","family":"Vesey","sequence":"additional","affiliation":[{"name":"Kidney Disease Research Collaborative, Centre for Health Services Research, The University of Queensland Translational Research Institute, Brisbane 4102, Australia"},{"name":"Department of Nephrology, Princess Alexandra Hospital, Brisbane 4075, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8732-7908","authenticated-orcid":false,"given":"Glenda C.","family":"Gobe","sequence":"additional","affiliation":[{"name":"Kidney Disease Research Collaborative, Centre for Health Services Research, The University of Queensland Translational Research Institute, Brisbane 4102, Australia"},{"name":"School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia"},{"name":"NHMRC Centre of Research Excellence for CKD, QLD, UQ Health Sciences, Royal Brisbane, and Women\u2019s Hospital, Brisbane 4029, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soisungwan","family":"Satarug","sequence":"additional","affiliation":[{"name":"Kidney Disease Research Collaborative, Centre for Health Services Research, The University of Queensland Translational Research Institute, Brisbane 4102, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"468","DOI":"10.2337\/diacare.26.2.468","article-title":"Urinary cadmium, impaired fasting glucose, and diabetes in the NHANES III","volume":"26","author":"Schwartz","year":"2003","journal-title":"Diabetes Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/j.ijheh.2014.06.005","article-title":"Association between urinary cadmium levels and prediabetes in the NHANES 2005\u20132010 population","volume":"217","author":"Wallia","year":"2014","journal-title":"Int. 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