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Smoking-Induced Risk of Osteoporosis Is Partly Mediated by Cadmium From Tobacco Smoke : The MrOS Sweden Study

Li, Huiqi LU ; Wallin, Maria ; Barregard, Lars ; Sallsten, Gerd ; Lundh, Thomas LU ; Ohlsson, Claes ; Mellström, Dan and Andersson, Eva M. (2020) In Journal of Bone and Mineral Research 35(8). p.1424-1429
Abstract

Cigarette smoking is a risk factor for osteoporosis and bone fracture. Moreover, smoking causes exposure to cadmium, which is a known risk factor for osteoporosis. It is hypothesized that part of smoking-induced osteoporosis may be mediated via cadmium from tobacco smoke. We investigated this hypothesis using mediation analysis in a Swedish cohort of elderly men. This study was performed in 886 elderly men from the Swedish cohort of the Osteoporotic Fractures in Men (MrOS) study. Urinary samples, bone mineral density (BMD), smoking data, and other background information were obtained at baseline in 2002–2004. Urinary cadmium was analyzed in baseline samples and adjusted for creatinine. The cohort was followed until August 2018 for... (More)

Cigarette smoking is a risk factor for osteoporosis and bone fracture. Moreover, smoking causes exposure to cadmium, which is a known risk factor for osteoporosis. It is hypothesized that part of smoking-induced osteoporosis may be mediated via cadmium from tobacco smoke. We investigated this hypothesis using mediation analysis in a Swedish cohort of elderly men. This study was performed in 886 elderly men from the Swedish cohort of the Osteoporotic Fractures in Men (MrOS) study. Urinary samples, bone mineral density (BMD), smoking data, and other background information were obtained at baseline in 2002–2004. Urinary cadmium was analyzed in baseline samples and adjusted for creatinine. The cohort was followed until August 2018 for fracture incidence, based on the X-ray register. Mediation analysis was conducted to evaluate the indirect effect (via cadmium) of smoking on both BMD and fractures. Time to first fracture was analyzed using the accelerated failure time (AFT) model and Aalen's additive hazard model. The mean level of urinary cadmium was 0.25 μg/g creatinine. There were significant inverse associations between smoking and total body, total hip, and trochanter BMD. The indirect effects via cadmium were estimated to be 43% of the total effects of smoking for whole-body BMD, and even more for total hip and trochanter BMD. Smoking was also associated with higher risk of all fractures and major osteoporosis fractures. The indirect effects via cadmium were largest in nonvertebral osteoporosis fractures and hip fractures, constituting at least one-half of the total effects, in both the AFT and Aalen's model. The findings in this study provide evidence that cadmium exposure from tobacco smoke plays an important role in smoking-induced osteoporosis

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
BONE MINERAL DENSITY, CADMIUM, OSTEOPOROSIS, PROSPECTIVE COHORT, SMOKING
in
Journal of Bone and Mineral Research
volume
35
issue
8
pages
6 pages
publisher
AMBMR
external identifiers
  • scopus:85082923769
  • pmid:32191351
ISSN
0884-0431
DOI
10.1002/jbmr.4014
language
English
LU publication?
yes
id
e42d194b-3a84-46a8-b4b8-355c171c7afb
date added to LUP
2020-05-08 15:18:02
date last changed
2021-05-25 02:02:06
@article{e42d194b-3a84-46a8-b4b8-355c171c7afb,
  abstract     = {<p>Cigarette smoking is a risk factor for osteoporosis and bone fracture. Moreover, smoking causes exposure to cadmium, which is a known risk factor for osteoporosis. It is hypothesized that part of smoking-induced osteoporosis may be mediated via cadmium from tobacco smoke. We investigated this hypothesis using mediation analysis in a Swedish cohort of elderly men. This study was performed in 886 elderly men from the Swedish cohort of the Osteoporotic Fractures in Men (MrOS) study. Urinary samples, bone mineral density (BMD), smoking data, and other background information were obtained at baseline in 2002–2004. Urinary cadmium was analyzed in baseline samples and adjusted for creatinine. The cohort was followed until August 2018 for fracture incidence, based on the X-ray register. Mediation analysis was conducted to evaluate the indirect effect (via cadmium) of smoking on both BMD and fractures. Time to first fracture was analyzed using the accelerated failure time (AFT) model and Aalen's additive hazard model. The mean level of urinary cadmium was 0.25 μg/g creatinine. There were significant inverse associations between smoking and total body, total hip, and trochanter BMD. The indirect effects via cadmium were estimated to be 43% of the total effects of smoking for whole-body BMD, and even more for total hip and trochanter BMD. Smoking was also associated with higher risk of all fractures and major osteoporosis fractures. The indirect effects via cadmium were largest in nonvertebral osteoporosis fractures and hip fractures, constituting at least one-half of the total effects, in both the AFT and Aalen's model. The findings in this study provide evidence that cadmium exposure from tobacco smoke plays an important role in smoking-induced osteoporosis</p>},
  author       = {Li, Huiqi and Wallin, Maria and Barregard, Lars and Sallsten, Gerd and Lundh, Thomas and Ohlsson, Claes and Mellström, Dan and Andersson, Eva M.},
  issn         = {0884-0431},
  language     = {eng},
  number       = {8},
  pages        = {1424--1429},
  publisher    = {AMBMR},
  series       = {Journal of Bone and Mineral Research},
  title        = {Smoking-Induced Risk of Osteoporosis Is Partly Mediated by Cadmium From Tobacco Smoke : The MrOS Sweden Study},
  url          = {http://dx.doi.org/10.1002/jbmr.4014},
  doi          = {10.1002/jbmr.4014},
  volume       = {35},
  year         = {2020},
}