Long-Term Sex-Specific Effects of Cadmium Exposure on Osteoporosis and Bone Density: A 10-Year Community-Based Cohort Study

This study explored the long-term effects of cadmium (Cd) exposure on osteoporosis incidence and bone mineral density (BMD). This retrospective cohort study included men aged >= 50 years and post-menopausal women from the 2001-2002 Korea Genome and Epidemiology Study. Participants previously diagnosed with osteoporosis were excluded. Blood Cd concentrations were measured and categorized as <0.5, 0.5-1.0, and >1.0 mu g/L. BMD was measured using quantitative ultrasound. Osteoporosis was diagnosed when the T-score was <=-2.5. Confounders that affect exposure and outcome were controlled. Osteoporosis incidence and differences in BMD (Delta BMD) were assessed until 2012. The osteoporosis incidence among 243 participants who were followed up for an average of 6.3 years was 22.2%. In all the participants, a dose-response relationship was observed between blood Cd and incident osteoporosis and Delta BMD (both p-for-trend < 0.01). After adjusting for age, sex, smoking, physical activity, body mass index, creatinine, and baseline BMD, a blood Cd concentration of >1.0 mu g/L was an independent risk factor for incident osteoporosis and decrements in Delta BMD. In women, blood Cd concentrations of >0.5 mu g/L increased the risk for osteoporosis. Exposure to Cd prospectively increases the risk for osteoporosis and decrements of Delta BMD, particularly in women, even in lower doses of Cd.