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Blood cadmium is associated with increased fracture risk in never-smokers - results from a case-control study using data from the Malmö Diet and Cancer cohort

Wallin, Maria ; Andersson, Eva M. and Engström, Gunnar LU (2024) In Bone 179.
Abstract

Background: Several studies have shown associations between cadmium (Cd) exposure and an increased risk of fractures. However, the size of the risk is still unclear and proper adjustment for smoking is a challenge. The aim of this study was to quantify the association between dietary cadmium measured in blood and fracture risk in the general Swedish population through a large population-based case-control study in never-smokers. Methods: The study included 2113 incident cases with osteoporosis-related fractures and the same number of age- and sex-matched controls in never-smokers from the Swedish population-based Malmö Diet and Cancer study cohort. Cd in blood (B-Cd) was analyzed at baseline (1991–1996). Incident osteoporosis-related... (More)

Background: Several studies have shown associations between cadmium (Cd) exposure and an increased risk of fractures. However, the size of the risk is still unclear and proper adjustment for smoking is a challenge. The aim of this study was to quantify the association between dietary cadmium measured in blood and fracture risk in the general Swedish population through a large population-based case-control study in never-smokers. Methods: The study included 2113 incident cases with osteoporosis-related fractures and the same number of age- and sex-matched controls in never-smokers from the Swedish population-based Malmö Diet and Cancer study cohort. Cd in blood (B-Cd) was analyzed at baseline (1991–1996). Incident osteoporosis-related fractures (of the hip, distal radius, and proximal humerus) up to the year 2014 were identified using the National Patient Register. Associations between B-Cd and fractures were analyzed using logistic regression. Results: Median B-Cd was 0.22 μg/L (P25 = 0.16, P75 = 0.31) among 2103 cases and 0.21 (P25 = 0.15, P75 = 0.30) among 2105 controls. The risk of fracture was significantly increased (OR 1.58; 95 % confidence interval 1.08–2.31, per μg/L of B-Cd), after adjustment for age, sex, BMI, physical activity, and fiber consumption. In analyses by cadmium quartiles, the OR increased monotonically and was significant in the highest quartile of B-Cd (for B-Cd > 0.31 versus B-Cd < 0.15 μg/L; OR 1.21; 95 % confidence interval 1.01–1.45). Conclusion: Even modestly increased blood cadmium in never-smokers is associated with increased risk of incident osteoporosis-related fractures.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cadmium, Diseases and disorders of/related to bone, Epidemiology, Fractures, General population studies, Osteoporosis
in
Bone
volume
179
article number
116989
publisher
Elsevier
external identifiers
  • pmid:38072370
  • scopus:85180760918
ISSN
8756-3282
DOI
10.1016/j.bone.2023.116989
language
English
LU publication?
yes
id
2ccbeaeb-e5ec-4f07-afbe-c95ac348516c
date added to LUP
2024-02-12 11:45:43
date last changed
2024-04-14 04:02:18
@article{2ccbeaeb-e5ec-4f07-afbe-c95ac348516c,
  abstract     = {{<p>Background: Several studies have shown associations between cadmium (Cd) exposure and an increased risk of fractures. However, the size of the risk is still unclear and proper adjustment for smoking is a challenge. The aim of this study was to quantify the association between dietary cadmium measured in blood and fracture risk in the general Swedish population through a large population-based case-control study in never-smokers. Methods: The study included 2113 incident cases with osteoporosis-related fractures and the same number of age- and sex-matched controls in never-smokers from the Swedish population-based Malmö Diet and Cancer study cohort. Cd in blood (B-Cd) was analyzed at baseline (1991–1996). Incident osteoporosis-related fractures (of the hip, distal radius, and proximal humerus) up to the year 2014 were identified using the National Patient Register. Associations between B-Cd and fractures were analyzed using logistic regression. Results: Median B-Cd was 0.22 μg/L (P25 = 0.16, P75 = 0.31) among 2103 cases and 0.21 (P25 = 0.15, P75 = 0.30) among 2105 controls. The risk of fracture was significantly increased (OR 1.58; 95 % confidence interval 1.08–2.31, per μg/L of B-Cd), after adjustment for age, sex, BMI, physical activity, and fiber consumption. In analyses by cadmium quartiles, the OR increased monotonically and was significant in the highest quartile of B-Cd (for B-Cd &gt; 0.31 versus B-Cd &lt; 0.15 μg/L; OR 1.21; 95 % confidence interval 1.01–1.45). Conclusion: Even modestly increased blood cadmium in never-smokers is associated with increased risk of incident osteoporosis-related fractures.</p>}},
  author       = {{Wallin, Maria and Andersson, Eva M. and Engström, Gunnar}},
  issn         = {{8756-3282}},
  keywords     = {{Cadmium; Diseases and disorders of/related to bone; Epidemiology; Fractures; General population studies; Osteoporosis}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Bone}},
  title        = {{Blood cadmium is associated with increased fracture risk in never-smokers - results from a case-control study using data from the Malmö Diet and Cancer cohort}},
  url          = {{http://dx.doi.org/10.1016/j.bone.2023.116989}},
  doi          = {{10.1016/j.bone.2023.116989}},
  volume       = {{179}},
  year         = {{2024}},
}