{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:28:24Z","timestamp":1790803704143,"version":"4.1.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2010,8,23]],"date-time":"2010-08-23T00:00:00Z","timestamp":1282521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>All people are exposed to cadmium (Cd) via food; smokers are additionally exposed. High Cd exposure is associated with severe bone damage, but the public health impact in relation to osteoporosis and fractures at low environmental exposure remains to be clarified. Within the population-based Swedish Mammography Cohort, we assessed urinary Cd [U-Cd, \u00b5g\/g of creatinine (cr)] as a marker of lifetime exposure and bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) among 2688 women. Register-based information on fractures was retrieved from 1997 to 2009. Associations were evaluated by multivariable regression analyses. In linear regression, U-Cd was inversely associated with BMD at the total body (p\u2009&amp;lt;\u2009.001), femoral neck (p\u2009=\u2009.025), total hip (p\u2009=\u2009.004), lumbar spine (p\u2009=\u2009.088), and volumetric femoral neck (p\u2009=\u2009.013). In comparison with women with U-Cd\u2009&amp;lt;\u20090.50\u2009\u00b5g\/g of cr, those with U-Cd \u2265 0.75\u2009\u00b5g\/g of cr had odds ratios (ORs) of 2.45 [95% confidence interval (CI) 1.51\u20133.97] and 1.97 (95% CI 1.24\u20133.14) for osteoporosis at the femoral neck and lumbar spine, respectively. Among never-smokers, the corresponding ORs were 3.47 (95% CI 1.46\u20138.23) and 3.26 (95% CI 1.44\u20137.38). For any first fracture (n\u2009=\u2009395), the OR was 1.16 (95% CI 0.89\u20131.50) comparing U-Cd \u2265 0.50\u2009\u00b5g\/g of cr with lower levels. Among never-smokers, the ORs (95% CIs) were 2.03 (1.33\u20133.09) for any first fracture, 2.06 (1.28\u20133.32) for first osteoporotic fracture, 2.18 (1.20\u20133.94) for first distal forearm fracture, and 1.89 (1.25\u20132.85) for multiple incident fractures. U-Cd at low environmental exposure from food in a general population of women showed modest but significant association with both BMD and fractures, especially in never-smokers, indicating a larger concern than previously known. \u00a9 2011 American Society for Bone and Mineral Research.<\/jats:p>","DOI":"10.1002\/jbmr.224","type":"journal-article","created":{"date-parts":[[2010,8,29]],"date-time":"2010-08-29T11:52:04Z","timestamp":1283082724000},"page":"486-495","source":"Crossref","is-referenced-by-count":146,"title":["Long-term cadmium exposure and the association with bone mineral density and fractures in a population-based study among women"],"prefix":"10.1093","volume":"26","author":[{"given":"Annette","family":"Engstr\u00f6m","sequence":"first","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Micha\u00eblsson","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Section of Orthopaedics and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Suwazono","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicja","family":"Wolk","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Vahter","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agneta","family":"\u00c5kesson","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2010,8,23]]},"reference":[{"key":"2024020318053982300_bib1","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1289\/ehp.0800317","article-title":"Population toxicokinetic modeling of cadmium for health risk assessment","volume":"117","author":"Amzal","year":"2009","journal-title":"Environ Health Perspect."},{"key":"2024020318053982300_bib2","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.taap.2009.04.020","article-title":"Current status of cadmium as an environmental health problem","volume":"238","author":"J\u00e4rup","year":"2009","journal-title":"Toxicol Appl Pharmacol."},{"key":"2024020318053982300_bib3","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1359\/jbmr.2000.15.8.1579","article-title":"Low-level cadmium exposure and osteoporosis","volume":"15","author":"Alfv\u00e9n","year":"2000","journal-title":"J Bone Miner Res."},{"key":"2024020318053982300_bib4","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1016\/S0140-6736(98)09356-8","article-title":"Environmental exposure to cadmium, forearm bone density, and risk of fractures: prospective population study. Public Health and Environmental Exposure to Cadmium (PheeCad) Study Group","volume":"353","author":"Staessen","year":"1999","journal-title":"Lancet."},{"key":"2024020318053982300_bib5","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1359\/jbmr.2003.18.3.553","article-title":"Influence of environmental cadmium exposure on forearm bone density","volume":"18","author":"Wang","year":"2003","journal-title":"J Bone Miner Res."},{"key":"2024020318053982300_bib6","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1289\/ehp.8763","article-title":"Cadmium-induced effects on bone in a population-based study of women","volume":"114","author":"\u00c5kesson","year":"2006","journal-title":"Environ Health Perspect."},{"key":"2024020318053982300_bib7","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1289\/ehp.11452","article-title":"Urinary cadmium and osteoporosis in U.S. Women &gt;or= 50 years of age: NHANES 1988\u20131994 and 1999\u20132004","volume":"116","author":"Gallagher","year":"2008","journal-title":"Environ Health Perspect."},{"key":"2024020318053982300_bib8","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.envres.2004.03.004","article-title":"Environmental exposure to cadmium at a level insufficient to induce renal tubular dysfunction does not affect bone density among female Japanese farmers","volume":"97","author":"Horiguchi","year":"2005","journal-title":"Environ Res."},{"key":"2024020318053982300_bib9","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.envres.2009.08.008","article-title":"Exposure to cadmium and persistent organochlorine pollutants and its association with bone mineral density and markers of bone metabolism on postmenopausal women","volume":"109","author":"Rignell-Hydbom","year":"2009","journal-title":"Environ Res."},{"key":"2024020318053982300_bib10","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.envres.2009.12.003","article-title":"The effects of low environmental cadmium exposure on bone density","volume":"110","author":"Trzcinka-Ochocka","year":"2010","journal-title":"Environ Res."},{"key":"2024020318053982300_bib11","doi-asserted-by":"crossref","first-page":"2085","DOI":"10.1007\/s00198-005-2004-3","article-title":"Exposure to CB-153 and p,p'-DDE and bone mineral density and bone metabolism markers in middle-aged and elderly men and women","volume":"16","author":"Wallin","year":"2005","journal-title":"Osteoporos Int."},{"key":"2024020318053982300_bib12","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1359\/JBMR.040202","article-title":"Cadmium exposure and distal forearm fractures","volume":"19","author":"Alfv\u00e9n","year":"2004","journal-title":"J Bone Miner Res."},{"key":"2024020318053982300_bib13","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1001\/jama.296.11.1371","article-title":"Long-term fatty fish consumption and renal cell carcinoma incidence in women","volume":"296","author":"Wolk","year":"2006","journal-title":"JAMA."},{"key":"2024020318053982300_bib14","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/0013-9351(78)90126-3","article-title":"Urinary excretion of cadmium and zinc among persons from Sweden","volume":"15","author":"Elinder","year":"1978","journal-title":"Environ Res."},{"key":"2024020318053982300_bib15","author":"The National Board of Health and Welfare"},{"issue":"(Suppl 2)","key":"2024020318053982300_bib16","doi-asserted-by":"crossref","first-page":"S493","DOI":"10.1055\/s-2001-18605","article-title":"Diabetes mellitus a risk for osteoporosis?","volume":"109","author":"Leidig-Bruckner","year":"2001","journal-title":"Exp Clin Endocrinol Diabetes."},{"key":"2024020318053982300_bib17","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1093\/ije\/24.4.771","article-title":"Diet and hip fracture risk: a case-control study. Study Group of the Multiple Risk Survey on Swedish Women for Eating Assessment","volume":"24","author":"Micha\u00eblsson","year":"1995","journal-title":"Int J Epidemiol."},{"key":"2024020318053982300_bib18","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1177\/096032719801700603","article-title":"Urinary cadmium as indicator of renal cadmium in humans: an autopsy study","volume":"17","author":"Orlowski","year":"1998","journal-title":"Hum Exp Toxicol."},{"key":"2024020318053982300_bib19","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.tox.2008.12.009","article-title":"Cadmium interacts with the transport of essential micronutrients in the mammary gland - a study in rural Bangladeshi women","volume":"257","author":"Kippler","year":"2009","journal-title":"Toxicology."},{"key":"2024020318053982300_bib20","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1007\/s10654-008-9273-z","article-title":"Validity of self-reported total physical activity questionnaire among older women","volume":"23","author":"Orsini","year":"2008","journal-title":"Eur J Epidemiol."},{"key":"2024020318053982300_bib21","doi-asserted-by":"crossref","first-page":"2776","DOI":"10.1210\/jc.2003-030551","article-title":"Volumetric bone density at the femoral neck as a common measure of hip fracture risk for men and women","volume":"89","author":"Center","year":"2004","journal-title":"J Clin Endocrinol Metab."},{"key":"2024020318053982300_bib22","author":"WHO","year":"1994"},{"key":"2024020318053982300_bib23","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1097\/EDE.0b013e318181319e","article-title":"Identification of incident injuries in hospital discharge registers","volume":"19","author":"Gedeborg","year":"2008","journal-title":"Epidemiology."},{"key":"2024020318053982300_bib24","doi-asserted-by":"crossref","first-page":"2865","DOI":"10.1002\/sim.3107","article-title":"Scaling regression inputs by dividing by two standard deviations","volume":"27","author":"Gelman","year":"2008","journal-title":"Stat Med."},{"key":"2024020318053982300_bib25","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/S0169-2607(97)00043-6","article-title":"Gaining more flexibility in Cox proportional hazards regression models with cubic spline functions","volume":"54","author":"Heinzl","year":"1997","journal-title":"Comput Methods Programs Biomed."},{"key":"2024020318053982300_bib26","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/0140-6736(90)92201-R","article-title":"Renal effects of cadmium body burden of the general population","volume":"336","author":"Buchet","year":"1990","journal-title":"Lancet."},{"key":"2024020318053982300_bib27","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.bone.2007.11.001","article-title":"A reference standard for the description of osteoporosis","volume":"42","author":"Kanis","year":"2008","journal-title":"Bone."},{"key":"2024020318053982300_bib28","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.taap.2009.05.015","article-title":"Cadmium osteotoxicity in experimental animals: mechanisms and relationship to human exposures","volume":"238","author":"Bhattacharyya","year":"2009","journal-title":"Toxicol Appl Pharmacol."},{"key":"2024020318053982300_bib29","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1002\/jbmr.22","article-title":"Occupational cadmium exposure and calcium excretion, bone density and osteoporosis in men","volume":"25","author":"Nawrot","year":"2010","journal-title":"J Bone Miner Res."},{"key":"2024020318053982300_bib30","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1289\/ehp.11167","article-title":"Bone resorption and environmental exposure to cadmium in women: a population study","volume":"116","author":"Schutte","year":"2008","journal-title":"Environ Health Perspect."},{"key":"2024020318053982300_bib31","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1016\/j.bone.2004.07.010","article-title":"Low-level lifetime exposure to cadmium decreases skeletal mineralization and enhances bone loss in aged rats","volume":"35","author":"Brz\u00f3ska","year":"2004","journal-title":"Bone."},{"key":"2024020318053982300_bib32","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.bone.2003.12.002","article-title":"Mineral status and mechanical properties of lumbar spine of female rats chronically exposed to various levels of cadmium","volume":"34","author":"Brz\u00f3ska","year":"2004","journal-title":"Bone."},{"key":"2024020318053982300_bib33","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.envres.2008.10.008","article-title":"Cadmium-induced bone effect is not mediated via low serum 1,25-dihydroxy vitamin D","volume":"109","author":"Engstr\u00f6m","year":"2009","journal-title":"Environ Res."}],"container-title":["Journal of Bone and Mineral Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjbmr.224","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/26\/3\/486\/56558655\/224_ftp.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/26\/3\/486\/56558655\/224_ftp.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T10:51:59Z","timestamp":1710327119000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbmr\/article\/26\/3\/486-495\/7598058"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,8,23]]},"references-count":33,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2010,8,23]]},"published-print":{"date-parts":[[2011,3,1]]}},"URL":"https:\/\/doi.org\/10.1002\/jbmr.224","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.8650956.9154054","asserted-by":"object"}]},"ISSN":["0884-0431","1523-4681"],"issn-type":[{"value":"0884-0431","type":"print"},{"value":"1523-4681","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2011,3,1]]},"published":{"date-parts":[[2010,8,23]]}}}