Association between Environmental Cadmium Exposure and Osteoporosis Risk in Postmenopausal Women: A Systematic Review and Meta-Analysis

Carlos Tadashi Kunioka, Maria Conceição Manso and Márcia Carvalho ()
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Carlos Tadashi Kunioka: FP-I3ID, FP-BHS, University Fernando Pessoa, 4249-004 Porto, Portugal
Maria Conceição Manso: FP-I3ID, FP-BHS, University Fernando Pessoa, 4249-004 Porto, Portugal
Márcia Carvalho: FP-I3ID, FP-BHS, University Fernando Pessoa, 4249-004 Porto, Portugal

IJERPH, 2022, vol. 20, issue 1, 1-15

Abstract: Osteoporosis is a common and serious health issue among postmenopausal women. We conducted a systematic review and meta-analysis study to determine whether environmental exposure to cadmium (Cd) is a risk factor for postmenopausal osteoporosis. A PROSPERO-registered review of the literature was performed on studies evaluating the relationship between urinary Cd (UCd) concentration, an indicator of long-term Cd exposure, and bone mineral density or osteoporosis in women aged 50 years and older. PubMed, Embase, Science Direct, Web of Science, and B-on databases were searched for articles published between 2008 and 2021. The association between UCd levels and osteoporosis risk was assessed by pooled odds ratio (OR) and 95% confidence interval (CI) using random-effect models. Ten cross-sectional studies were included in the qualitative analysis, of which five were used for meta-analysis. We separately assessed the risk of osteoporosis in women exposed to Cd at low environmental levels ( n = 5895; UCd ≥ 0.5 μg/g creatinine versus UCd < 0.5 μg/g creatinine) and high environmental levels ( n = 1864; UCd ≥ 5 μg/g creatinine versus UCd < 5 μg/g creatinine). The pooled OR for postmenopausal osteoporosis was 1.95 (95% CI: 1.39–2.73, p < 0.001) in the low exposure level group and 1.99 (95% CI: 1.04–3.82, p = 0.040) in the high exposure level group. This study indicates that environmental Cd exposure, even at low levels, may be a risk factor for osteoporosis in postmenopausal women. Further research based on prospective studies is needed to validate these findings.

Keywords: environmental cadmium; bone density; osteoporosis; risk factor; menopause; women; meta-analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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