202189 Cadmium-associated hormonal and bone effects in women age 42 to 60 years; NHANES III

Wednesday, November 11, 2009: 10:35 AM

Carolyn M. Gallagher, MPA, MPH , Graduate Program in Public Health, SUNY Stony Brook, Stony Brook, NY
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.

Learning Objectives:
1. Describe the two negative feedback loops that affect follicle-stimulating hormone (FSH) production. 2. Explain the possible mechanism of action whereby cadmium may disrupt these processes of FSH inhibition. 3. Identify three measures of bone effects that have been associated with cadmium exposure in women.

Keywords: Environmental Exposures, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: completed Masters in Public Health; authored article on environmental cadmium exposure and osteoporosis that was published in Environmental Health Perspectives
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.