Advanced

Low-Level Cadmium Exposure Is Associated with Decreased Bone Mineral Density and Increased Risk of Incident Fractures in Elderly Men: The MrOS Sweden Study.

Wallin, Maria; Barregard, Lars; Sallsten, Gerd; Lundh, Thomas LU ; Karlsson, Magnus K LU ; Lorentzon, Mattias; Ohlsson, Claes and Mellström, Dan (2015) In Journal of Bone and Mineral Research
Abstract
One risk factor for osteoporosis which has attracted increasing attention in recent years is exposure to cadmium. The aim of this study was to examine the associations between low-level cadmium exposure, from diet and smoking, and BMD and incident fractures in elderly men. The study population consisted of 936 men from the Swedish cohort of the MrOS study, aged 70-81 years at inclusion (year 2002-2004), with reliable data on cadmium in urine (U-Cd) analyzed using inductively coupled plasma mass spectrometry in baseline samples. The participants also answered a questionnaire on lifestyle factors and medical history. BMD was measured at baseline using DXA in the total body, hip, and lumbar spine. During the follow-up period (until 2013), all... (More)
One risk factor for osteoporosis which has attracted increasing attention in recent years is exposure to cadmium. The aim of this study was to examine the associations between low-level cadmium exposure, from diet and smoking, and BMD and incident fractures in elderly men. The study population consisted of 936 men from the Swedish cohort of the MrOS study, aged 70-81 years at inclusion (year 2002-2004), with reliable data on cadmium in urine (U-Cd) analyzed using inductively coupled plasma mass spectrometry in baseline samples. The participants also answered a questionnaire on lifestyle factors and medical history. BMD was measured at baseline using DXA in the total body, hip, and lumbar spine. During the follow-up period (until 2013), all new fractures were registered by date and type. Associations between BMD and U-Cd were assessed using multiple linear regression, and associations between incident fractures and baseline U-Cd were analyzed using Cox regression. In both cases, a number of potential confounders and other risk factors (e.g. age, smoking, BMI, and physical activity) were included in the models. We found significant negative associations between U-Cd and BMD, with lower BMD (4-8%) for all sites in the fourth quartile of U-Cd, using the first quartile as the reference. In addition, we found positive associations between U-Cd and incident fractures, especially non-vertebral osteoporosis fractures in the fourth quartile of U-Cd, with hazard ratios of 1.8-3.3 in the various models. U-Cd as a continuous variable was significantly associated with non-vertebral osteoporosis fractures (adjusted hazard ratio 1.3-1.4 per µg Cd/g creatinine), also in never-smokers, but not with the other fracture groups (all fractures, hip fractures, vertebral fractures, and other fractures). Our results indicate that even relatively low cadmium exposure through diet and smoking increases the risk of low BMD and osteoporosis-related fractures in elderly men. This article is protected by copyright. All rights reserved. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Bone and Mineral Research
publisher
AMBMR
external identifiers
  • pmid:26572678
  • scopus:84952684460
  • wos:000374008200005
ISSN
1523-4681
DOI
10.1002/jbmr.2743
language
English
LU publication?
yes
id
d116ec14-19a8-4321-a1a0-fd330cfd0a6d (old id 8235405)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26572678?dopt=Abstract
date added to LUP
2015-12-05 16:52:11
date last changed
2017-10-22 04:55:30
@article{d116ec14-19a8-4321-a1a0-fd330cfd0a6d,
  abstract     = {One risk factor for osteoporosis which has attracted increasing attention in recent years is exposure to cadmium. The aim of this study was to examine the associations between low-level cadmium exposure, from diet and smoking, and BMD and incident fractures in elderly men. The study population consisted of 936 men from the Swedish cohort of the MrOS study, aged 70-81 years at inclusion (year 2002-2004), with reliable data on cadmium in urine (U-Cd) analyzed using inductively coupled plasma mass spectrometry in baseline samples. The participants also answered a questionnaire on lifestyle factors and medical history. BMD was measured at baseline using DXA in the total body, hip, and lumbar spine. During the follow-up period (until 2013), all new fractures were registered by date and type. Associations between BMD and U-Cd were assessed using multiple linear regression, and associations between incident fractures and baseline U-Cd were analyzed using Cox regression. In both cases, a number of potential confounders and other risk factors (e.g. age, smoking, BMI, and physical activity) were included in the models. We found significant negative associations between U-Cd and BMD, with lower BMD (4-8%) for all sites in the fourth quartile of U-Cd, using the first quartile as the reference. In addition, we found positive associations between U-Cd and incident fractures, especially non-vertebral osteoporosis fractures in the fourth quartile of U-Cd, with hazard ratios of 1.8-3.3 in the various models. U-Cd as a continuous variable was significantly associated with non-vertebral osteoporosis fractures (adjusted hazard ratio 1.3-1.4 per µg Cd/g creatinine), also in never-smokers, but not with the other fracture groups (all fractures, hip fractures, vertebral fractures, and other fractures). Our results indicate that even relatively low cadmium exposure through diet and smoking increases the risk of low BMD and osteoporosis-related fractures in elderly men. This article is protected by copyright. All rights reserved.},
  author       = {Wallin, Maria and Barregard, Lars and Sallsten, Gerd and Lundh, Thomas and Karlsson, Magnus K and Lorentzon, Mattias and Ohlsson, Claes and Mellström, Dan},
  issn         = {1523-4681},
  language     = {eng},
  month        = {11},
  publisher    = {AMBMR},
  series       = {Journal of Bone and Mineral Research},
  title        = {Low-Level Cadmium Exposure Is Associated with Decreased Bone Mineral Density and Increased Risk of Incident Fractures in Elderly Men: The MrOS Sweden Study.},
  url          = {http://dx.doi.org/10.1002/jbmr.2743},
  year         = {2015},
}