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Duk-Hee Lee,¹ Ji-Sun Lim,¹ Kyungeun Song,² Yongchool Boo,³ and David R. Jacobs Jr.^4,5

¹Department of Preventive Medicine and Health Promotion Research Center, ²Department of Clinical Pathology, School of Medicine, and ³Department of Molecular Biology, School of Medicine, Kyungpook National University, Daegu, South Korea; ⁴Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA; ⁵Department of Nutrition, University of Oslo, Oslo, Norway

Abstract
Although oxidative stress has been proposed as a mechanism of lead and cadmium toxicity mostly based on in vitro experiments or animal studies, it is uncertain whether this mechanism is relevant in the pathogenesis of lead- or cadmium-related diseases in the general population with low environmental exposure to lead and cadmium. We examined associations of blood lead and urinary cadmium levels with oxidative stress markers of serum -glutamyltransferase (GGT) , vitamin C, carotenoids, and vitamin E among 10,098 adult participants in the third U.S. National Health and Nutrition Examination Survey. After adjusting for race, sex, and age (plus serum total cholesterol in the case of serum carotenoids and vitamin E) , blood lead and urinary cadmium levels both showed graded associations, positive with serum GGT and inverse with serum vitamin C, carotenoids, and vitamin E (p for trend < 0.01, respectively) . These associations were consistently observed among most subgroups: non-Hispanic white, non-Hispanic black, men, women, all age groups, nondrinkers, drinkers, nonsmokers, ex-smokers, current smokers, and body mass index (< 25, 25-29.9, and ≥ 30) . The strong association of blood lead and urinary cadmium levels with oxidative stress markers in this population suggests that oxidative stress should be considered in the pathogenesis of lead- and cadmium-related diseases even among people with low environmental exposure to lead and cadmium. Key words: cadmium, carotenoid, -glutamyltransferase, lead, oxidative stress, vitamin C, vitamin E. Environ Health Perspect 114: 350-354 (2006) . doi:10.1289/ehp.8518 available via http://dx.doi.org/ [Online 15 November 2005]

Address correspondence to D.-H. Lee, Department of Preventive Medicine, School of Medicine, Kyungpook University, 101 Dongin-dong, Jung-gu, Daegu, Korea 700-422. Telephone: 82-53-420-6960. Fax: 82-53-425-2447. E-mail: lee_dh@knu.ac.kr

This study was partly supported in Korea by Kyungpook National University Research Fund (2003) , and the Korea Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea (A050349) ; in the United States by a grant from the National Heart, Lung, and Blood Institute (R01 H1 53560) (Young Adults Longitudinal Trends in Antioxidants) .

The authors declare they have no competing financial interests.

Received 21 July 2005 ; accepted 15 November 2005.