The Association Between Cadmium Exposure and Osteoporosis: A Longitudinal Study and Predictive Model in a Chinese Female Population

Objective: The association between cadmium exposure and osteoporosis has been rarely reported in longitudinal studies. In this study, we investigated the association between osteoporosis and cadmium exposure and developed predictive models in women in a longitudinal cohort.Materials and Methods: In...

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Main Authors: Miaomiao Wang, Xinru Wang, Jingjing Liu, Zhongqiu Wang, Taiyi Jin, Guoying Zhu, Xiao Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-11-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2021.762475/full
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author Miaomiao Wang
Xinru Wang
Jingjing Liu
Zhongqiu Wang
Taiyi Jin
Guoying Zhu
Xiao Chen
author_facet Miaomiao Wang
Xinru Wang
Jingjing Liu
Zhongqiu Wang
Taiyi Jin
Guoying Zhu
Xiao Chen
author_sort Miaomiao Wang
collection DOAJ
description Objective: The association between cadmium exposure and osteoporosis has been rarely reported in longitudinal studies. In this study, we investigated the association between osteoporosis and cadmium exposure and developed predictive models in women in a longitudinal cohort.Materials and Methods: In total, 488 women living in southeastern China were included at baseline (1998). Cadmium in blood (BCd) and urine (UCd) and also renal dysfunction biomarkers and bone mineral density (BMD) were determined both at baseline and follow-up. A total of 307 subjects were finally included after excluding subjects that did not have exposure or effect biomarkers. Osteoporosis was defined based on T score ≤ −2.5. Multiple linear regression and multivariate logistic analysis were used to show the association between baseline data and follow-up osteoporosis. Based on the identified associated factors, nomograms were developed to graphically calculate the individual risk of osteoporosis.Results: The baseline BMD in subjects with osteoporosis was significantly lower than that in subjects without osteoporosis (0.59 vs. 0.71 g/cm2, p < 0.05). The prevalence of low bone mass at baseline was higher in subjects with osteoporosis than in those without osteoporosis (23.5 vs. 7.2%, p = 0.001). Logistic regression analysis demonstrated that age [odds ratio (OR) = 1.21, 95% confidence interval (CI): 1.16–1.27], UCd (OR = 1.03, 95% CI: 1.002–1.06) and the presence of low BMD (OR = 3.84, 95% CI: 1.49–9.89) were independent risk factors for osteoporosis. For those subjects with normal baseline BMD, age, UCd, and baseline BMD were also independent risk factors for osteoporosis. The OR value was 1.16 (95% CI: 1.10–1.22) for age, 2.27 (95% CI: 1.03–4.99) for UCd > 10 μg/g creatinine, and 0.39 (95% CI: 0.21–0.72) for BMDbaseline. We developed two nomograms to predict the risk of osteoporosis. The area under the curve was 0.88 (95% CI: 0.84–0.92) for total population and was 0.88 (95% CI: 0.84–0.92) for subjects with normal baseline BMD, respectively.Conclusion: Baseline age, UCd, and BMD were associated with follow-up osteoporosis in women. Nomograms showed good performance in predicting the risk of osteoporosis.
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spelling doaj.art-ad903e37f0cf477391f3534ada7b0e902022-12-21T22:57:45ZengFrontiers Media S.A.Frontiers in Public Health2296-25652021-11-01910.3389/fpubh.2021.762475762475The Association Between Cadmium Exposure and Osteoporosis: A Longitudinal Study and Predictive Model in a Chinese Female PopulationMiaomiao Wang0Xinru Wang1Jingjing Liu2Zhongqiu Wang3Taiyi Jin4Guoying Zhu5Xiao Chen6Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Occupational and Environmental Medicine, School of Public Health, Fudan University, Shanghai, ChinaInstitute of Radiation Medicine, Fudan University, Shanghai, ChinaDepartment of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaObjective: The association between cadmium exposure and osteoporosis has been rarely reported in longitudinal studies. In this study, we investigated the association between osteoporosis and cadmium exposure and developed predictive models in women in a longitudinal cohort.Materials and Methods: In total, 488 women living in southeastern China were included at baseline (1998). Cadmium in blood (BCd) and urine (UCd) and also renal dysfunction biomarkers and bone mineral density (BMD) were determined both at baseline and follow-up. A total of 307 subjects were finally included after excluding subjects that did not have exposure or effect biomarkers. Osteoporosis was defined based on T score ≤ −2.5. Multiple linear regression and multivariate logistic analysis were used to show the association between baseline data and follow-up osteoporosis. Based on the identified associated factors, nomograms were developed to graphically calculate the individual risk of osteoporosis.Results: The baseline BMD in subjects with osteoporosis was significantly lower than that in subjects without osteoporosis (0.59 vs. 0.71 g/cm2, p < 0.05). The prevalence of low bone mass at baseline was higher in subjects with osteoporosis than in those without osteoporosis (23.5 vs. 7.2%, p = 0.001). Logistic regression analysis demonstrated that age [odds ratio (OR) = 1.21, 95% confidence interval (CI): 1.16–1.27], UCd (OR = 1.03, 95% CI: 1.002–1.06) and the presence of low BMD (OR = 3.84, 95% CI: 1.49–9.89) were independent risk factors for osteoporosis. For those subjects with normal baseline BMD, age, UCd, and baseline BMD were also independent risk factors for osteoporosis. The OR value was 1.16 (95% CI: 1.10–1.22) for age, 2.27 (95% CI: 1.03–4.99) for UCd > 10 μg/g creatinine, and 0.39 (95% CI: 0.21–0.72) for BMDbaseline. We developed two nomograms to predict the risk of osteoporosis. The area under the curve was 0.88 (95% CI: 0.84–0.92) for total population and was 0.88 (95% CI: 0.84–0.92) for subjects with normal baseline BMD, respectively.Conclusion: Baseline age, UCd, and BMD were associated with follow-up osteoporosis in women. Nomograms showed good performance in predicting the risk of osteoporosis.https://www.frontiersin.org/articles/10.3389/fpubh.2021.762475/fullcadmiumwomenboneosteoporosislongitudinal study
spellingShingle Miaomiao Wang
Xinru Wang
Jingjing Liu
Zhongqiu Wang
Taiyi Jin
Guoying Zhu
Xiao Chen
The Association Between Cadmium Exposure and Osteoporosis: A Longitudinal Study and Predictive Model in a Chinese Female Population
Frontiers in Public Health
cadmium
women
bone
osteoporosis
longitudinal study
title The Association Between Cadmium Exposure and Osteoporosis: A Longitudinal Study and Predictive Model in a Chinese Female Population
title_full The Association Between Cadmium Exposure and Osteoporosis: A Longitudinal Study and Predictive Model in a Chinese Female Population
title_fullStr The Association Between Cadmium Exposure and Osteoporosis: A Longitudinal Study and Predictive Model in a Chinese Female Population
title_full_unstemmed The Association Between Cadmium Exposure and Osteoporosis: A Longitudinal Study and Predictive Model in a Chinese Female Population
title_short The Association Between Cadmium Exposure and Osteoporosis: A Longitudinal Study and Predictive Model in a Chinese Female Population
title_sort association between cadmium exposure and osteoporosis a longitudinal study and predictive model in a chinese female population
topic cadmium
women
bone
osteoporosis
longitudinal study
url https://www.frontiersin.org/articles/10.3389/fpubh.2021.762475/full
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