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Blood cadmium levels unrelated to fracture risk in women
Blood cadmium levels do not affect the risk for first incident fracture in middle-aged women, but higher levels may increase the risk for mortality, according to findings published in Osteoporosis International.
“Most studies on cadmium exposure, [bone mineral density] and fracture risk considered the relationship between urinary cadmium and not blood cadmium as analyzed in this study,” the researchers wrote. “The concentration of [blood cadmium] reflects mostly recent exposure but also long-term exposure, whereas [urinary cadmium] is a measure of total body burden of [cadmium] reflecting the long-term exposure.”
Louise Moberg, a doctoral student in the department of obstetrics and gynecology at Lund University and Skåne University Hospital in Sweden, and colleagues evaluated data from the Malmö Diet and Cancer Study cardiovascular cohort on 2,920 women (mean age, 58 years) with available blood cadmium measurements and background questionnaire to determine the association between blood cadmium levels at baseline and risk for first incident fracture. Median total follow-up time from inclusion to the study endpoint was 20.2 years.
Participants were divided into four groups based on their cadmium levels: quartile 1 (< 0.18 µg/L; n = 730), quartile 2 (0.18-0.28 µg/L; n = 730), quartile 3 (0.28-0.51 µg/L; n = 730) and quartile 4 (> 0.51 µg/L; n = 730).
During follow-up, 998 participants sustained a first incident fracture; the most common was distal radius fracture (29.5%), followed by hip fracture (19.9%) and upper humerus fracture (8.9%). No difference was found in time to fracture or first incident fractures between participants with cadmium levels in the first and fourth quartiles. However, more participants with cadmium quartile 4 levels died (21%) compared with participants with cadmium quartile 1 levels (11.2%; P < .001). Increasing age and BMI, current smoking and diabetes were independent factors for mortality in the multivariate-adjusted Cox regression.
Increasing levels of blood cadmium at baseline did not affect the risk for first nonvertebral osteoporotic fractures when comparing quartile 4 with quartile 1 (HR = 1.02; 95% CI, 0.82-1.27) in the multivariate-adjusted Cox regression.
“High blood cadmium levels did not increase fracture risk, but doubled the overall mortality rate in middle-aged women,” the researchers wrote. “Gastric ulcer disease was associated with increased fracture risk after adjustment for other risk factors in this group of women.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.