title: Increased urinary cobalt and whole blood concentrations of cadmium and lead in women with uterine leiomyomata: Findings from the ENDO Study.
abstract: Multiple trace elements have estrogen receptor activity, but the association of these elements with uterine leiomyoma has not been defined. A cohort of 473 women aged 18-44 undergoing surgery for benign gynecologic indications provided whole blood and urine specimens for trace element analysis, which was performed by inductively coupled plasma mass spectrometry. Twenty elements were analyzed in blood and 3 in urine. The surgeon documented whether fibroids were present. Geometric mean concentrations were compared between women with and without fibroids, and logistic regression models were generated to assess the impact of the concentration of each trace element on the odds of fibroids. In multivariate regressions, odds of a fibroid diagnosis were higher with increased whole blood cadmium (AOR 1.44, 95% CI 1.02, 2.04) and lead (AOR 1.31 95% CI 1.02, 1.69), and urine cobalt (AOR 1.31, 95% CI 1.02, 1.70). Urinary cadmium and lead were not related to fibroid diagnosis. Increased exposure to trace elements may contribute to fibroid growth, and fibroids may serve as a reservoir for these elements. Differences between urinary and whole blood findings merit further investigation, as urinary cadmium has been considered a superior marker of exposure.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, 50 North 1900 East, Ste. 2B200, Salt Lake City, UT 84108, United States. Electronic address: erica.johnstone@hsc.utah.edu.
authors.forename: Erica B
authors.initials: EB
authors.lastname: Johnstone
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Health, 6100 Executive Boulevard, Rockville, MD 20852, United States.
authors.forename: Germaine M Buck
authors.initials: GM
authors.lastname: Louis
authors.affiliation: Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, and the Department of Environmental Health Sciences, The University at Albany, New York 12201, United States.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Parsons
authors.affiliation: Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, and the Department of Environmental Health Sciences, The University at Albany, New York 12201, United States.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Steuerwald
authors.affiliation: Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, and the Department of Environmental Health Sciences, The University at Albany, New York 12201, United States.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Palmer
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Health, 6100 Executive Boulevard, Rockville, MD 20852, United States.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Health, 6100 Executive Boulevard, Rockville, MD 20852, United States.
authors.forename: Liping
authors.initials: L
authors.lastname: Sun
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, 50 North 1900 East, Ste. 2B200, Salt Lake City, UT 84108, United States.
authors.forename: Ahmad O
authors.initials: AO
authors.lastname: Hammoud
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, 50 North 1900 East, Ste. 2B200, Salt Lake City, UT 84108, United States.
authors.forename: Jessie
authors.initials: J
authors.lastname: Dorais
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, 50 North 1900 East, Ste. 2B200, Salt Lake City, UT 84108, United States.
authors.forename: C Matthew
authors.initials: CM
authors.lastname: Peterson
mesh_terms: D000293:Adolescent; D000328:Adult; D002104:Cadmium / Q000633:toxicity / Q000652:urine*; D016022:Case-Control Studies; D003035:Cobalt / Q000633:toxicity / Q000652:urine*; D005260:Female; D006801:Humans; D007854:Lead / Q000633:toxicity / Q000652:urine*; D007889:Leiomyoma / Q000097:blood* / Q000139:chemically induced / Q000652:urine; D016015:Logistic Models; D014131:Trace Elements / Q000097:blood / Q000633:toxicity / Q000652:urine; D014594:Uterine Neoplasms / Q000097:blood* / Q000139:chemically induced / Q000652:urine; D055815:Young Adult
chemical_list: D014131:Trace Elements; D002104:Cadmium; D007854:Lead; D003035:Cobalt
keywords: Cadmium; Fibroids; Lead; Leiomyoma; Mercury; Metals; Toxic exposures; Trace elements