Engström Annette, Skerving Staffan, Lidfeldt Jonas, Burgaz Ann, Lundh Thomas, Samsioe Göran, Vahter Marie, Akesson Agneta
Division of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
Environ Res. 2009 Feb;109(2):188-92. doi: 10.1016/j.envres.2008.10.008. Epub 2008 Dec 6.
Cadmium is a widespread environmental pollutant, which is associated with increased risk of osteoporosis. It has been proposed that cadmium's toxic effect on bone is exerted via impaired activation of vitamin D, secondary to the kidney effects. To test this, we assessed the association of cadmium-induced bone and kidney effects with serum 1,25-dihydroxyvitamin D (1,25(OH)(2)D); measured by enzyme immunoassay. For the assessment, we selected 85 postmenopausal women, based on low (0.14-0.39 microg/L) or high (0.66-2.1 microg/L) urinary cadmium, within a cross-sectional population-based women's health survey in Southern Sweden. We also measured 25-hydroxy vitamin D, cadmium in blood, bone mineral density and several markers of bone remodeling and kidney effects. Although there were clear differences in both kidney and bone effect markers between women with low and high cadmium exposure, the 1,25(OH)(2)D concentrations were not significantly different (median, 111 pmol/L (5-95th percentile, 67-170 pmol/L) in low- and 125 pmol/L (66-200 pmol/L) in high-cadmium groups; p=0.08). Also, there was no association between 1,25(OH)(2)D and markers of bone or kidney effects. It is concluded that the low levels of cadmium exposure present in the studied women, although high enough to be associated with lower bone mineral density and increased bone resorption, were not associated with lower serum concentrations of 1,25(OH)(2)D. Hence, decreased circulating levels of 1,25(OH)(2)D are unlikely to be the proposed link between cadmium-induced effects on kidney and bone.
镉是一种广泛存在的环境污染物,与骨质疏松风险增加有关。有人提出,镉对骨骼的毒性作用是通过损害维生素D的活化来实现的,这继发于其对肾脏的影响。为了验证这一点,我们通过酶免疫测定法评估了镉诱导的骨骼和肾脏效应与血清1,25-二羟基维生素D(1,25(OH)₂D)之间的关联。为了进行评估,我们在瑞典南部一项基于人群的横断面女性健康调查中,根据尿镉水平低(0.14 - 0.39微克/升)或高(0.66 - 2.1微克/升),选择了85名绝经后女性。我们还测量了25-羟基维生素D、血液中的镉、骨矿物质密度以及几种骨重塑和肾脏效应标志物。尽管镉暴露水平低和高的女性在肾脏和骨骼效应标志物方面存在明显差异,但1,25(OH)₂D浓度并无显著差异(低镉组中位数为111皮摩尔/升(第5 - 95百分位数,67 - 170皮摩尔/升),高镉组为125皮摩尔/升(66 - 200皮摩尔/升);p = 0.08)。此外,1,25(OH)₂D与骨骼或肾脏效应标志物之间没有关联。研究得出结论,在所研究的女性中,低水平的镉暴露虽然高到足以与较低的骨矿物质密度和增加的骨吸收相关,但与较低的血清1,25(OH)₂D浓度无关。因此,1,25(OH)₂D循环水平降低不太可能是镉对肾脏和骨骼诱导效应之间的假定联系。