Environmental cadmium exposure and osteoporosis: a review.

To review the published literature investigating the association between cadmium exposure and osteoporosis. A review of published peer-reviewed literature based on a priori criteria was completed. Odds ratios (OR) were abstracted or estimated from observational studies to calculate a pooled OR using inverse variance weighted random effects models. The review identified seven studies with a pooled OR of OR = 2.22 (95 % CI: 1.16, 4.28) [I (2) = 54.8 % (p < 0.05)] (comparing highest urine cadmium category to lowest). In women over the age of 50 years, the pooled OR was 1.82 (95 % CI: 1.63, 2.02) [I (2) = 73.1 % (p < 0.05)]. A dose response evaluation (six studies) suggested increasing odds for osteoporosis with increasing urine cadmium levels. This review detected an association between cadmium exposure and the occurrence of osteoporosis in a small number of cross-sectional studies which requires confirmation in using prospective study design.