Association between blood cadmium and the likelihood of developing human papillomavirus infection: A combination of NHANES and clinical study

Objective To determine whether blood cadmium levels are associated with the likelihood of developing human papillomavirus infection in women aged 20–59 years. Methods In this cross-sectional study, we analyzed data from 7815 women in the 2005–2016 National Health and Nutrition Examination Survey. The nonlinear association was examined using generalized weighted models and smoothed curves, with subgroup analyses by age, body mass index, and other covariates. An independent validation cohort of 50 human papillomavirus–positive patients and 50 human papillomavirus–negative controls from Yuejianglou Community Health Center under the Medical Alliance of The Second Hospital of Nanjing was also used. Results Human papillomavirus–positive individuals exhibited higher average blood cadmium levels (0.6 ± 0.74 μg/L) than human papillomavirus–negative individuals (0.48 ± 0.53 μg/L). A positive, nonlinear relationship was found. Subgroup analysis revealed that each unit increase in blood cadmium levels increased the risk of human papillomavirus infection by 34% in women aged 46–59 years with a body mass index of 25–30 kg/m 2 . The validation cohort confirmed significantly higher cadmium levels in human papillomavirus–positive patients. Conclusions Our research indicates a potential link between blood cadmium levels and human papillomavirus infection status, warranting further investigation.