title: Cadmium Exposure and Risk of Any Fracture: A PRISMA-Compliant Systematic Review and Meta-Analysis.
abstract: Several observational studies have investigated the relation between cadmium exposure and risk of any fracture. However, the results from epidemiological studies for the association are inconsistent.We conducted a meta-analysis to evaluate the relationship between cadmium exposure and risk of any fracture. The pertinent studies were identified by a search of PubMed and Embase databases from 1966 to June 2015.Seven articles involving 21,941 fracture cases and 504,346 participants were included. The meta-analysis showed that the pooled relative risk of any fracture for the highest versus lowest category of cadmium concentration was 1.30 (95% confidence interval = 1.13-1.49). In subgroup analyses, the significant association remained consistent when stratified by study type, geographical region, method of cadmium exposure assessment, and gender.Our meta-analysis showed that a high cadmium exposure may be a risk factor for any fracture. However, this result should be interpreted cautiously because of the heterogeneity among studies and existence of publication bias. Additional large, high-quality prospective studies are needed to evaluate the association between cadmium exposure and the risk of development of fracture.
authors.affiliation: From the Department of Oral and Maxillary Surgery (XC, XY, GH, JS), Gui Zhou Provincial People's Hospital, Guiyang; Department of Stomatology and Center for Evidence-Based Medicine and Clinical Research (YN), Taihe Hospital, Hubei University of Medicine, Shiyan; Department of Oral Medicine (QD), Chengdu Yafei Dental Dashijie Clinic, Chengdu; and Department of Orthodontics (JP), Stomatology Hospital of Guiyang, Guiyang, China.
authors.forename: Xianlin
authors.initials: X
authors.lastname: Cheng
authors.forename: Yuming
authors.initials: Y
authors.lastname: Niu
authors.forename: Qingyang
authors.initials: Q
authors.lastname: Ding
authors.forename: Xinhai
authors.initials: X
authors.lastname: Yin
authors.forename: Guanglei
authors.initials: G
authors.lastname: Huang
authors.forename: Juxiang
authors.initials: J
authors.lastname: Peng
authors.forename: Jukun
authors.initials: J
authors.lastname: Song
mesh_terms: D002104:Cadmium / Q000633:toxicity*; D050723:Fractures, Bone / Q000139:chemically induced*; D006801:Humans; D064887:Observational Studies as Topic
chemical_list: D002104:Cadmium