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

Author

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  • Carlos Tadashi Kunioka

    (FP-I3ID, FP-BHS, University Fernando Pessoa, 4249-004 Porto, Portugal
    Western Paraná State University (UNIOESTE), Cascavel 85819-110, Paraná, Brazil)

  • Maria Conceição Manso

    (FP-I3ID, FP-BHS, University Fernando Pessoa, 4249-004 Porto, Portugal
    Faculty of Health Sciences, University Fernando Pessoa, 4200-150 Porto, Portugal
    LAQV, REQUIMTE, University of Porto, 4050-313 Porto, Portugal)

  • Márcia Carvalho

    (FP-I3ID, FP-BHS, University Fernando Pessoa, 4249-004 Porto, Portugal
    Faculty of Health Sciences, University Fernando Pessoa, 4200-150 Porto, Portugal
    Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
    UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal)

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.

Suggested Citation

  • Carlos Tadashi Kunioka & Maria Conceição Manso & Márcia Carvalho, 2022. "Association between Environmental Cadmium Exposure and Osteoporosis Risk in Postmenopausal Women: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 20(1), pages 1-15, December.
    • Handle: RePEc:gam:jijerp:v:20:y:2022:i:1:p:485-:d:1017488
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    References listed on IDEAS

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    1. Giuseppe Genchi & Maria Stefania Sinicropi & Graziantonio Lauria & Alessia Carocci & Alessia Catalano, 2020. "The Effects of Cadmium Toxicity," IJERPH, MDPI, vol. 17(11), pages 1-24, May.
    2. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
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