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Hip Fracture Risk and Cadmium in Erythrocytes: A Nested Case-Control Study with Prospectively Collected Samples
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
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2014 (English)In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 94, no 2, 183-190 p.Article in journal (Refereed) Published
Abstract [en]

Several studies have investigated the relation between bone mass density and cadmium exposure, but only few studies have been performed on fractures and biomarkers of cadmium. This study analyzed the association between hip fracture risk and cadmium in erythrocytes (Ery-Cd). Prospective samples from the Northern Sweden Health and Disease Study's biobank were used for 109 individuals who later in life had sustained a low-trauma hip fracture, matched with two controls of the same age and gender. The mean concentration of Ery-Cd (±SD) in case samples was 1.3 ± 1.4 versus 0.9 ± 1.0 μg/L in controls. The odds ratio (OR) was 1.63 [95 % confidence interval (CI) 1.10-2.42] for suffering a hip fracture for each microgram per liter increase in Ery-Cd. However, when taking smoking into consideration (never, former, or current), neither Ery-Cd nor smoking showed a statistically significant increase in fracture risk. Using multiple conditional logistic regression with BMI, height, and smoking, the estimated OR for a 1-μg/L increase in Ery-Cd was 1.52 (95 % CI 0.77-2.97). Subgroup analysis showed an increased fracture risk among women (OR = 1.94, 95 % CI 1.18-3.20, for a 1 μg/L increase), which also remained in the multiple analysis (OR = 3.33, 95 % CI 1.29-8.56). This study shows that fracture risk is associated with Ery-Cd. It is, however, not possible to draw firm conclusions on whether cadmium is the causal factor or whether other smoking-related factors cause this association. Subgroup analysis shows that cadmium is a risk factor for hip fracture among women.

Place, publisher, year, edition, pages
Springer, 2014. Vol. 94, no 2, 183-190 p.
Keyword [en]
Cadmium, Environmental exposure, Heavy metal, Hip fracture, Prospective
National Category
Clinical Medicine Environmental Health and Occupational Health Orthopedics
URN: urn:nbn:se:umu:diva-84733DOI: 10.1007/s00223-013-9796-5ISI: 000330827700007PubMedID: 24101229OAI: diva2:688880
Formas, 2005-875Swedish Research Council, K2006-72X-20155013EU, European Research Council, FOOD-CT-2006-016253
Available from: 2014-01-17 Created: 2014-01-17 Last updated: 2015-04-22Bibliographically approved

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Nilsson Sommar, JohanPettersson-Kymmer, UlrikaSvensson, OlleHallmans, GöranBergdahl, Ingvar A.
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Occupational and Environmental MedicineDepartment of Pharmacology and Clinical NeuroscienceDepartment of Public Health and Clinical MedicineOrthopaedicsNutritional ResearchDepartment of Biobank Research
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Calcified Tissue International
Clinical MedicineEnvironmental Health and Occupational HealthOrthopedics

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