{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T07:48:18Z","timestamp":1778312898968,"version":"3.51.4"},"reference-count":69,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T00:00:00Z","timestamp":1672185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"national funds","award":["UIDP\/04378\/2020"],"award-info":[{"award-number":["UIDP\/04378\/2020"]}]},{"name":"national funds","award":["UIDB\/04378\/2020"],"award-info":[{"award-number":["UIDB\/04378\/2020"]}]},{"name":"national funds","award":["LA\/P\/0140\/2020"],"award-info":[{"award-number":["LA\/P\/0140\/2020"]}]},{"name":"Associated Laboratory i4HB","award":["UIDP\/04378\/2020"],"award-info":[{"award-number":["UIDP\/04378\/2020"]}]},{"name":"Associated Laboratory i4HB","award":["UIDB\/04378\/2020"],"award-info":[{"award-number":["UIDB\/04378\/2020"]}]},{"name":"Associated Laboratory i4HB","award":["LA\/P\/0140\/2020"],"award-info":[{"award-number":["LA\/P\/0140\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>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 \u2265 0.5 \u03bcg\/g creatinine versus UCd &lt; 0.5 \u03bcg\/g creatinine) and high environmental levels (n = 1864; UCd \u2265 5 \u03bcg\/g creatinine versus UCd &lt; 5 \u03bcg\/g creatinine). The pooled OR for postmenopausal osteoporosis was 1.95 (95% CI: 1.39\u20132.73, p &lt; 0.001) in the low exposure level group and 1.99 (95% CI: 1.04\u20133.82, 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.<\/jats:p>","DOI":"10.3390\/ijerph20010485","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T05:42:48Z","timestamp":1672206168000},"page":"485","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Association between Environmental Cadmium Exposure and Osteoporosis Risk in Postmenopausal Women: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"20","author":[{"given":"Carlos Tadashi","family":"Kunioka","sequence":"first","affiliation":[{"name":"FP-I3ID, FP-BHS, University Fernando Pessoa, 4249-004 Porto, Portugal"},{"name":"Western Paran\u00e1 State University (UNIOESTE), Cascavel 85819-110, Paran\u00e1, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1774-1337","authenticated-orcid":false,"given":"Maria Concei\u00e7\u00e3o","family":"Manso","sequence":"additional","affiliation":[{"name":"FP-I3ID, FP-BHS, University Fernando Pessoa, 4249-004 Porto, Portugal"},{"name":"Faculty of Health Sciences, University Fernando Pessoa, 4200-150 Porto, Portugal"},{"name":"LAQV, REQUIMTE, University of Porto, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9884-4751","authenticated-orcid":false,"given":"M\u00e1rcia","family":"Carvalho","sequence":"additional","affiliation":[{"name":"FP-I3ID, FP-BHS, University Fernando Pessoa, 4249-004 Porto, Portugal"},{"name":"Faculty of Health Sciences, University Fernando Pessoa, 4200-150 Porto, Portugal"},{"name":"Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal"},{"name":"UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s00198-018-4704-5","article-title":"European guidance for the diagnosis and management of osteoporosis in postmenopausal women","volume":"30","author":"Kanis","year":"2019","journal-title":"Osteoporos. 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