Urinary cadmium, osteopenia, and osteoporosis in the US population.
CONCLUSIONS
The association between cadmium and osteoporosis in a multiethnic population is unclear. We found that urinary cadmium is consistently associated with osteopenia and osteoporosis in the Third National Health and Nutrition Examination Survey, regardless of age, sex, race, and smoking status. Cadmium exposure may be an independent risk factor for osteoporosis.


BACKGROUND
Our purpose was to test whether cadmium exposure is associated with a higher prevalence of osteopenia and osteoporosis in the general US population and selected subgroups.


METHODS
We used multinomial logistic regression to analyze data on 10,978 subjects (aged 30-90) from the Third National Health and Nutrition Examination Survey. We studied the association of urinary cadmium levels (adjusted for urinary creatinine) and the prevalence of osteopenia and osteoporosis as defined by the World Health Organization.


RESULTS
After adjustment for age, sex, ethnicity, body mass index, calcium intake, and physical inactivity, odds ratios (ORs) for osteopenia and osteoporosis increased dose dependently with two urinary cadmium levels (in micrograms of urinary cadmium per grams of urinary creatinine: level I, 1.00-1.99 mcg/g; level II, > or =2.00 mcg/g). Osteopenia results were as follows: level I OR, 1.49 (95% confidence interval [CI], 1.24-1.80); level II OR, 2.05 (95% CI, 1.52-2.78). Osteoporosis results were as follows: level I OR, 1.78 (95% CI, 1.26-2.52); level II OR, 3.80 (95% CI, 2.36-6.14). The association was consistent in all age, sex, race, and smoking status subgroups.


CONCLUSIONS
Cadmium exposure may be a potential risk factor for osteopenia and osteoporosis in the general US population.
Wu
Q
Q
Biostatistics, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ 85259, USA. wu.qing@mayo.edu
Magnus
J H
JH
Hentz
J G
JG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001851:Bone Diseases, Metabolic / Q000139:chemically induced / Q000453:epidemiology / Q000652:urine*; D002104:Cadmium / Q000633:toxicity / Q000652:urine*; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis; D004784:Environmental Monitoring / Q000379:methods; D004812:Epidemiologic Methods; D062665:Epidemiological Monitoring; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000453:epidemiology / Q000652:urine; D012907:Smoking / Q000453:epidemiology / Q000652:urine; D014481:United States / Q000453:epidemiology
D002104:Cadmium