Long-Term Cadmium Exposure and the Association With Bone Mineral Density and Fractures in a Population-Based Study Among Women
Long-Term Cadmium Exposure and the Association With Bone Mineral Density and Fractures in a Population-Based Study Among Women
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DOI：
10.1002/jbmr.224
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发表时间：
2011-03-01
影响因子：
6.2
通讯作者：
Akesson, Agneta
中科院分区：
文献类型：
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作者：
Engstrom, Annette;Michaelsson, Karl;Akesson, Agneta
所有人都会通过食物接触镉 (Cd)；吸烟者也会受到额外的暴露。高镉暴露与严重的骨损伤有关，但低环境暴露下与骨质疏松和骨折相关的公共健康影响仍有待澄清。在以人群为基础的瑞典乳房 X 线摄影队列中，我们通过双能 X 射线吸收测定法 (DXA) 对 2688 名女性的尿镉 [U-Cd，μ g/g 肌酐 (cr)] 进行了评估，将其作为终生暴露和骨矿物质密度 (BMD) 的标志。检索 1997 年至 2009 年期间基于登记的骨折信息。通过多变量回归分析评估关联性。在线性回归中，U-Cd 与全身 (p < .001)、股骨颈 (p = .025)、全髋 (p = .004)、腰椎 (p = .088) 和体积股骨颈 (p = .013) 的 BMD 呈负相关。与 U-Cd < 0.50 μg/g cr 的女性相比，U-Cd >= 0.75 μg/g cr 的女性股骨颈和腰椎骨质疏松的比值比 (OR) 分别为 2.45 [95% 置信区间 (CI) 1.51-3.97] 和 1.97 (95% CI 1.24-3.14)，分别。在从不吸烟者中，相应的 OR 为 3.47 (95% CI 1.46-8.23) 和 3.26 (95% CI 1.44-7.38)。对于任何首次骨折 (n = 395)，与 U-Cd >= 0.50 μg/g 的 cr 和较低水平相比，OR 为 1.16 (95% CI 0.89-1.50)。在从不吸烟者中，首次骨折的 OR (95% CI) 为 2.03 (1.33-3.09)，首次骨质疏松性骨折为 2.06 (1.28-3.32)，首次前臂远端骨折为 2.18 (1.20-3.94)，多发性骨折为 1.89 (1.25-2.85)。在一般女性人群中，从食物中摄入的 U-Cd 含量较低，与 BMD 和骨折有适度但显着的相关性，特别是对于从不吸烟的人，这表明人们对这一问题的关注程度比之前已知的要大。 (c) 2011 年美国骨与矿物质研究学会。
All people are exposed to cadmium (Cd) via food; smokers are additionally exposed. High Cd exposure is associated with severe bone damage, but the public health impact in relation to osteoporosis and fractures at low environmental exposure remains to be clarified. Within the population-based Swedish Mammography Cohort, we assessed urinary Cd [U-Cd, mu g/g of creatinine (cr)] as a marker of lifetime exposure and bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) among 2688 women. Register-based information on fractures was retrieved from 1997 to 2009. Associations were evaluated by multivariable regression analyses. In linear regression, U-Cd was inversely associated with BMD at the total body (p < .001), femoral neck (p = .025), total hip (p = .004), lumbar spine (p = .088), and volumetric femoral neck (p = .013). In comparison with women with U-Cd < 0.50 mu g/g of cr, those with U-Cd >= 0.75 mu g/g of cr had odds ratios (ORs) of 2.45 [95% confidence interval (CI) 1.51-3.97] and 1.97 (95% CI 1.24-3.14) for osteoporosis at the femoral neck and lumbar spine, respectively. Among never-smokers, the corresponding ORs were 3.47 (95% CI 1.46-8.23) and 3.26 (95% CI 1.44-7.38). For any first fracture (n = 395), the OR was 1.16 (95% CI 0.89-1.50) comparing U-Cd >= 0.50 mu g/g of cr with lower levels. Among never-smokers, the ORs (95% CIs) were 2.03 (1.33-3.09) for any first fracture, 2.06 (1.28-3.32) for first osteoporotic fracture, 2.18 (1.20-3.94) for first distal forearm fracture, and 1.89 (1.25-2.85) for multiple incident fractures. U-Cd at low environmental exposure from food in a general population of women showed modest but significant association with both BMD and fractures, especially in never-smokers, indicating a larger concern than previously known. (c) 2011 American Society for Bone and Mineral Research.