Can cadmium toxicity be a driving force for iron deficiency anemia – a systematic review and meta-analysis

Introduction There is a great deal of evidence that cadmium toxicity can have a significant impact on nutritional deficiencies, particularly iron deficiency. Therefore, in this study, we aimed to investigate the effect of cadmium toxicity on iron deficiency by meta-analysis method in order to clarify the previously obtained results. Content Web of Science, Scopus, and Pubmed databases were used for systematic search until December 17th, 2024. RevMan 5.4 software was used to perform meta-analysis. Summary Six studies were suitable for evaluating environmental/occupational cadmium exposure. In this analysis, serum cadmium levels were meaningfully higher in the cadmium-exposed groups (p=0.0005), while serum iron levels were meaningfully lower (p=0.0004). Forty-five studies were evaluated to include all diseases in which serum cadmium and serum iron levels were measured and included. According to this analysis, serum cadmium levels were meaningfully higher in case groups than in healthy controls (p<0.00001), while serum iron levels were meaningfully lower (p<0.00001). We also performed subgroup analysis exclusively for cancer patients and observed that serum cadmium levels were significantly elevated in cancer patients (p<0.00001), whereas serum iron levels were significantly decreased (p<0.00001). Outlook This is the first meta-analysis assessing the association between cadmium toxicity and iron deficiency. Our findings demonstrate that cadmium may be effective in triggering iron deficiency anemia and inflammation-induced anemia by impairing iron metabolism. However, it should be noted that more detailed studies are needed to clarify these effects of cadmium.