Evidence map›Paper›PMID 28432383›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2017

Increased blood cadmium levels were not associated with increased fracture risk but with increased total mortality in women: the Malmö Diet and Cancer Study.

L Moberg, P M Nilsson, G Samsioe, G Sallsten, L Barregard, G Engström, C Borgfeldt

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 20 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

L MobergDepartment of Obstetrics and Gynaecology, Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden. louise.moberg@med.lu.se.ORCID 0000-0002-5120-819X
P M NilssonDepartment of Internal Medicine, Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
G SamsioeDepartment of Obstetrics and Gynaecology, Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden.
G SallstenDepartment of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
L BarregardDepartment of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
G EngströmDepartment of Internal Medicine, Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
C BorgfeldtDepartment of Obstetrics and Gynaecology, Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden.
Lund University · SESahlgrenska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study aimed to investigate if high levels of blood cadmium at baseline were associated with increased fracture risk during follow-up in middle-aged women. No increased fracture risk was observed during follow-up, but women with higher levels of cadmium had an increased overall mortality.

introductionExposure to high levels of cadmium has been associated with an increased fracture risk. The aim was to investigate a perceived association between low levels of blood cadmium (B-Cd) at baseline and risk of first incident fracture.

methodsFrom the population-based Malmö Diet and Cancer Study Cardiovascular cohort, 2920 middle-aged women with available background questionnaire and B-Cd measurements were included. Women were divided into quartiles (Q) according to their cadmium levels (Cd-Q1 <0.18 μg/L, Cd-Q2 0.18-0.28 μg/L, Cd-Q3 0.28-0.51 μg/L, and Cd-Q4 >0.51 μg/L). National registries were analysed for prospective risk of fractures or death. Associations between B-Cd and fracture risk were assessed by survival analysis (Cox regression analysis).

resultsIn total, 998 first incident fractures occurred in women during a follow-up lasting 20.2 years (median) (12.5-21.2 years) (25th-75th percentile). Women in Cd-Q4 were more often current smokers than in Cd-Q1 78.4 vs. 3.3% (p < 0.001) and the number of cigarettes smoked per day correlated with B-Cd (r = 0.49; p < 0.001). The risk of fracture was not associated with baseline B-Cd in adjusted models. The hazard ratio (HR) Cd-Q4 vs. Cd-Q1 was 1.06 (95% confidence interval (CI) 0.89-1.27). In the multivariate Cox regression, independent variables for increased fracture risk were history of gastric ulcer and increasing age, whereas increasing body mass index (BMI) lowered fracture risk. Overall mortality was significantly higher for women with high B-Cd, HR 2.06 (95% CI 1.57-2.69).

conclusionsHigher blood levels of cadmium did not increase fracture risk in middle-aged women but reduced overall survival.

Indexed as

Age FactorsBody Mass IndexCadmiumFemaleFollow-Up StudiesHumansKaplan-Meier EstimateMiddle AgedMortalityOsteoporotic FracturesRisk AssessmentSmokingStomach UlcerSwedenCadmiumCadmiumDiabetes mellitusFracture riskGastric ulcerMortalityWomen

Identifiers

PMID28432383
PMCPMC5524859
OpenAlexW2605497159

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.