Low-Level Cadmium Exposure Is Associated With Decreased Bone Mineral Density and Increased Risk of Incident Fractures in Elderly Men: The MrOS Sweden Study

Abstract

One risk factor for osteoporosis that has attracted increasing attention in recent years is exposure to cadmium. The aim of this study was to examine the associations between low‐level cadmium exposure, from diet and smoking, and bone mineral density (BMD) and incident fractures in elderly men. The study population consisted of 936 men from the Swedish cohort of the Osteoporotic Fractures in Men (MrOS) study, aged 70 to 81 years at inclusion (years 2002 to 2004), with reliable data on cadmium in urine (U‐Cd) analyzed using inductively coupled plasma mass spectrometry in baseline samples. The participants also answered a questionnaire on lifestyle factors and medical history. BMD was measured at baseline using dual‐energy X‐ray absorptiometry (DXA) in the total body, hip, and lumbar spine. During the follow‐up period (until 2013), all new fractures were registered by date and type. Associations between BMD and U‐Cd were assessed using multiple linear regression, and associations between incident fractures and baseline U‐Cd were analyzed using Cox regression. In both cases, a number of potential confounders and other risk factors (eg, age, smoking, body mass index [BMI], and physical activity) were included in the models. We found significant negative associations between U‐Cd and BMD, with lower BMD (4% to 8%) for all sites in the fourth quartile of U‐Cd, using the first quartile as the reference. In addition, we found positive associations between U‐Cd and incident fractures, especially nonvertebral osteoporosis fractures in the fourth quartile of U‐Cd, with hazard ratios of 1.8 to 3.3 in the various models. U‐Cd as a continuous variable was significantly associated with nonvertebral osteoporosis fractures (adjusted hazard ratio 1.3 to 1.4 per μg Cd/g creatinine), also in never‐smokers, but not with the other fracture groups (all fractures, hip fractures, vertebral fractures, and other fractures). Our results indicate that even relatively low cadmium exposure through diet and smoking increases the risk of low BMD and osteoporosis‐related fractures in elderly men. © 2015 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR).

Protective Effect of Chokeberry (<em>Aronia melanocarpa </em>L.) Extract Against Cadmium Impact on the Biomechanical Properties of the Femur: A Study in a Rat Model of Low and Moderate Lifetime Women Exposure to this Heavy Metal

“…More numerous epidemiological data provide evidence that important environmental risk factors for the increasing incidence of osteoporosis are toxic heavy metals, including cadmium (Cd) [1][2][3][8][9][10]. Due to the wide distribution of this metal in the environment and food pollution, as well as its presence in the tobacco smoke, the whole population is exposed to this metal during the lifetime [8][9][10][11][12].…”

“…Due to the wide distribution of this metal in the environment and food pollution, as well as its presence in the tobacco smoke, the whole population is exposed to this metal during the lifetime [8][9][10][11][12]. Bone damage is one of the main unfavourable health effects of long-term exposure to this xenobiotic in both human [1,[8][9][10][11][12] and experimental animals [13][14][15][16][17][18][19]. We have reported, on a rat model of environmental human exposure to Cd, that this metal disturbs bone metabolism and weakens biomechanical properties of long bones and lumbar spine vertebral bodies, and may even result in femoral neck and vertebral fractures [13][14][15][16][17][18].…”

“…We have reported, on a rat model of environmental human exposure to Cd, that this metal disturbs bone metabolism and weakens biomechanical properties of long bones and lumbar spine vertebral bodies, and may even result in femoral neck and vertebral fractures [13][14][15][16][17][18]. In recent years, more and more numerous epidemiological data have shown that even low-level lifetime exposure to this heavy metal may decrease bone mineral density (BMD) and contribute to osteoporosis with increased risk of bone fracture in the general population [1,[8][9][10]. Moreover, the forecasts indicate that exposure of the general population to this xenobiotic will increase in the future decades [11].…”

Review of polyphenol‐rich products as potential protective and therapeutic factors against cadmium hepatotoxicity

“…We have investigated the influence of an aqueous 0.1% chokeberry extract in a female rat model of low‐level (1 mg/kg diet) and moderate (5 mg/kg diet) chronic (up to 24 months) exposure to Cd reflecting the lifetime general population exposure to this xenobiotic in industrialized and developing countries. The concentrations of this heavy metal in the blood and urine (main indicators of exposure to Cd) of rats exposed to Cd 1 and 5 mg/kg diet (0.103‐0.324 μg/L and 0.085‐0.354 μg/g creatinine, respectively, and 0.584‐1.332 μg/L and 0.284‐0.820 μg/g creatinine, respectively) were within the ranges of its concentrations noted in the blood and urine of inhabitants of industrialized and developing countries (Choi et al, ; Fagerberg et al, ; Hyder et al, ; Kang et al, ; Wallin et al, ; Wang et al, ; Wu et al, )…”

“…Because environmental and occupational exposure to Cd is still a serious health problem (Fagerberg et al, ; Hyder et al, ; Lin et al, ; Satarug et al, , ; Wallin et al, ; Wang et al, ), particularly in industrialized and developing countries, it is of great importance to find an effective strategy to protect against the unfavorable effects of exposure to Cd and treatment of them. Among the potential protective and therapeutic factors, particularly promising not only in the prevention but also in the treatment of health outcomes of this metal intoxication in humans seem to be polyphenol‐rich dietary products.…”