In 936 Swedish men aged 70 to 81, higher urinary cadmium was associated with 4% to 8% lower bone mineral density and a higher risk of nonvertebral osteoporosis fractures, including in never-smokers.
Authors
- Wallin, M., Barregard, L., Sallsten, G., Lundh, T., Karlsson, M. K., Lorentzon, M., Ohlsson, C., & Mellström, D. (2016). , Journal of Bone and Mineral Research, 31(4), 732.
What was issued?
A study on low-level cadmium exposure and its effect on bone mineral density (BMD) and incident fractures in elderly men was issued as part of the MrOS Sweden study. This research analyzed 936 men aged 70 to 81, investigating the relationship between cadmium exposure, dietary intake, smoking habits, and bone health. It found significant negative associations between urinary cadmium (U-Cd) levels and BMD, indicating that higher levels of cadmium exposure resulted in lower BMD across various bone sites. The study also found an increased risk of fractures, particularly nonvertebral osteoporosis-related fractures, in men with higher cadmium levels.
Who is affected?
The affected populations in this study include elderly men, especially those exposed to cadmium through diet or smoking. This group is particularly vulnerable as cadmium accumulates in the body over time, and its negative effects on bone health can increase the risk of fractures and osteoporosis-related conditions. The study highlights the importance of monitoring environmental cadmium exposure, especially for populations such as elderly smokers and individuals with high dietary cadmium intake.
Most important findings
Urinary cadmium (U-Cd), measured by ICP-MS in baseline samples, was significantly and negatively associated with BMD measured by DXA in the total body, hip and lumbar spine. Men in the highest quartile of U-Cd had 4% to 8% lower BMD at all sites than men in the lowest quartile, after adjustment for age, smoking, body mass index, physical activity and other risk factors. During follow-up to 2013, U-Cd was positively associated with incident fractures, especially nonvertebral osteoporosis fractures, with hazard ratios of 1.8 to 3.3 for the highest versus the lowest quartile across the models. As a continuous variable, U-Cd was significantly associated with nonvertebral osteoporosis fractures (adjusted hazard ratio 1.3 to 1.4 per μg Cd/g creatinine), including in men who had never smoked, but not with all fractures, hip fractures, vertebral fractures or other fractures. The authors conclude that even relatively low cadmium exposure through diet and smoking increases the risk of low BMD and osteoporosis-related fractures in elderly men.
Key implications
The study adds prospective evidence that cadmium exposure at the low levels common in the general population, from diet and smoking, is associated with lower bone density and more osteoporosis-related fractures in older men. Because the association with nonvertebral osteoporosis fractures held in never-smokers, diet appears to be a relevant source on its own. For heavy metal testing and certification, this is relevant evidence that dietary cadmium matters for bone health even at relatively low, general-population exposure levels. As an observational study, it shows associations rather than proof of cause.
Citation
Wallin, M., Barregard, L., Sallsten, G., Lundh, T., Karlsson, M. K., Lorentzon, M., Ohlsson, C., & Mellström, D. (2016). Low‐Level Cadmium Exposure Is Associated With Decreased Bone Mineral Density and Increased Risk of Incident Fractures in Elderly Men: The MrOS Sweden Study.Journal of Bone and Mineral Research, 31(4), 732. https://doi.org/10.1002/jbmr.2743
Cadmium is a persistent heavy metal that accumulates in kidneys and bones. Dietary sources include cereals, cocoa, shellfish and vegetables, while smokers and industrial workers receive higher exposures. Studies link cadmium to kidney dysfunction, bone fractures and cancer.