Cadmium-associated hormonal and bone effects in women age 42 to 60 years; NHANES III

Environmental cadmium exposure has been associated with increased risk of decreased bone mineral density (BMD) and osteoporosis in mid-age and older women, and an inverse relationship has been reported between follicle-stimulating hormone (FSH) and BMD in mid-age women; however, the relationship between cadmium and FSH is uncertain, and the effects of both on bone health have not been evaluated in one study.

The objective was to evaluate the effects of urinary cadmium (UCd) on FSH levels; and of UCd and FSH on BMD and osteoporosis; in peri- and postmenopausal women age 42 to 60 years.

Data were obtained from the Third National Health Examination and Nutrition Survey. Statistical analysis was conducted using SAS (9.2) multiple regression procedures. Subset analysis was conducted by high/low body mass index (BMI) to proxy high/low estrogen levels.

UCd was associated with increased FSH in perimenopausal women (n=1050; β=0.53; SE=0.15; p≤0.01; R2=0.30); and in postmenopausal women with high BMI (n=1278; β=0.32; SE=0.15; p≤0.05; R2=0.27). BMD was inversely associated with UCd and FSH among perimenopausal/high BMI women (n=642). Among postmenopausal/high BMI women, an incremental UCd increase was associated with 81% greater odds for below normal BMD (OR=1.81; 95% CI=1.21, 2.71; p≤0.01). Among postmenopausal/low BMI women, an incremental increase in FSH was associated with 2.78 greater odds for osteoporosis (n=109; OR=2.78; 95% CI=1.43, 5.42; p≤0.01).

Results show that environmental cadmium exposure is associated with increased FSH, and FSH and UCd are associated with bone loss, in U.S. women age 42 to 60 years, both peri- and post-menopausal.