title: Environmental cadmium exposure and osteoporosis: a review.
abstract: OBJECTIVE
  To review the published literature investigating the association between cadmium exposure and osteoporosis.
  
  
  METHODS
  A review of published peer-reviewed literature based on a priori criteria was completed. Odds ratios (OR) were abstracted or estimated from observational studies to calculate a pooled OR using inverse variance weighted random effects models.
  
  
  RESULTS
  The review identified seven studies with a pooled OR of OR = 2.22 (95 % CI: 1.16, 4.28) [I (2) = 54.8 % (p < 0.05)] (comparing highest urine cadmium category to lowest). In women over the age of 50 years, the pooled OR was 1.82 (95 % CI: 1.63, 2.02) [I (2) = 73.1 % (p < 0.05)]. A dose response evaluation (six studies) suggested increasing odds for osteoporosis with increasing urine cadmium levels.
  
  
  CONCLUSIONS
  This review detected an association between cadmium exposure and the occurrence of osteoporosis in a small number of cross-sectional studies which requires confirmation in using prospective study design.
authors.affiliation: Department of Family Medicine, School of Medicine, University of Colorado, Mail Stop F443, 13991 E Montview Ave Aurora, Denver, CO, 80045, USA, Kathy.james@ucdenver.edu.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: James
authors.forename: Jaymie R
authors.initials: JR
authors.lastname: Meliker
mesh_terms: D015519:Bone Density / Q000187:drug effects; D002104:Cadmium; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D006801:Humans; D010024:Osteoporosis / Q000453:epidemiology*
chemical_list: D002104:Cadmium