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Low‐Level Cadmium Exposure and Osteoporosis
Author(s) -
Alfvén Tobias,
Elinder CarlGustaf,
Carlsson Margareta Dea,
Grubb Anders,
Hellström Lennart,
Persson Bodil,
Pettersson Conny,
Spång Gunnar,
Schütz Andrejs,
Järup Lars
Publication year - 2000
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1359/jbmr.2000.15.8.1579
Subject(s) - creatinine , medicine , cadmium , osteoporosis , proteinuria , renal function , endocrinology , osteomalacia , odds ratio , urology , kidney , chemistry , organic chemistry
Osteoporosis is a major cause of morbidity worldwide. A number of risk factors, such as age and gender, are well established. High cadmium exposure causes renal damage and in severe cases also causes osteoporosis and osteomalacia. We have examined whether long‐term low‐level cadmium exposure increases the risk of osteoporosis. Bone mineral density (BMD) in the forearm was measured in 520 men and 544 women, aged 16–81 years, environmentally or occupationally exposed to cadmium, using dual‐energy X‐ray absorptiometry (DXA) technique. Cadmium in urine was used as the dose estimate and protein HC was used as a marker of renal tubular damage. There was a clear dose‐response relation between cadmium dose and the prevalence of tubular proteinuria. Inverse relations were found between cadmium dose, tubular proteinuria, and BMD, particularly apparent in persons over 60 years of age. There was a dose‐response relation between cadmium dose and osteoporosis. The odds ratios (ORs) for men were 2.2 (95% CI, 1.0‐4.8) in the dose group 0.5‐3 nmol Cd/mmol creatinine and 5.3 (2.0‐14) in the highest dose category (≥3 nmol/mmol creatinine) compared with the lowest dose group (<0.5 nmol Cd/mmol creatinine). For women, the OR was 1.8 (0.65‐5.3) in the dose group 0.5‐3 nmol Cd/mmol creatinine. We conclude that exposure to low levels of cadmium is associated with an increased risk of osteoporosis.