The study included 2113 incident cases with osteoporosis-related fractures and the same number of age- and sex-matched controls in never-smokers from the Swedish population-based Malmö Diet and Cancer study cohort. Cd in blood (B-Cd) was analyzed at baseline (1991-1996). Incident osteoporosis-related fractures (of the hip, distal radius, and proximal humerus) up to the year 2014 were identified using the National Patient Register. Associations between B-Cd and fractures were analyzed using logistic regression.
Median B-Cd was 0.22 μg/L (P25 = 0.16, P75 = 0.31) among 2103 cases and 0.21 (P25 = 0.15, P75 = 0.30) among 2105 controls. The risk of fracture was significantly increased (OR 1.58; 95 % confidence interval 1.08-2.31, per μg/L of B-Cd), after adjustment for age, sex, BMI, physical activity, and fiber consumption. In analyses by cadmium quartiles, the OR increased monotonically and was significant in the highest quartile of B-Cd (for B-Cd > 0.31 versus B-Cd < 0.15 μg/L; OR 1.21; 95 % confidence interval 1.01-1.45).
Even modestly increased blood cadmium in never-smokers is associated with increased risk of incident osteoporosis-related fractures.
方法:该研究包括2113例骨质疏松症相关骨折的事件病例,以及相同数量的年龄和性别匹配的从不吸烟者,来自瑞典人群的马尔默饮食和癌症研究队列。在基线(1991-1996)分析血液中的Cd(B-Cd)。与骨质疏松相关的骨折(髋部,桡骨远端,和肱骨近端)直到2014年都是使用国家患者登记册确定的。采用logistic回归分析B-Cd与骨折的关系。
结果:在2103例中,B-Cd中位数为0.22μg/L(P25=0.16,P75=0.31),在2105例中为0.21(P25=0.15,P75=0.30)。骨折风险显著增加(OR1.58;95%置信区间1.08-2.31,每μg/LB-Cd),调整后的年龄,性别,BMI,身体活动,纤维消耗。在镉四分位数的分析中,OR单调增加,并且在B-Cd的最高四分位数中很显着(对于B-Cd>0.31和B-Cd<0.15μg/L;OR1.21;95%置信区间1.01-1.45)。
结论:即使不吸烟者的血镉水平略有升高,也会增加与骨质疏松相关的骨折发生率。