Li Dong, Lin HaoJie, Zhang Min, Meng Jing, Hu LiYou, Yu Bo
The Chinese Medicine College, Shandong University of Traditional Chinese Medicine, Jinan, China.
Jinan Blood Supply and Security Center, Jinan, China.
Front Med (Lausanne). 2021 Apr 16;8:648902. doi: 10.3389/fmed.2021.648902. eCollection 2021.
As society ages, the incidence of osteoporosis increases. In several studies, cadmium (Cd) is thought to be related to osteoporosis. However, there are conflicting reports about the relationship between Cd and the risk of osteoporosis and osteopenia. Therefore, the purpose of this meta-analysis was to explore the relationship between Cd and osteoporosis and osteopenia. Through a review of the literature, articles published in PubMed as of December 2020 were identified and the references of related publications and reviews were reviewed. Ultimately, 17 eligible articles were selected to determine the relationship between blood and urine Cd concentrations for the risk of osteoporosis or osteopenia. In this study, we performed a classification analysis, heterogeneity test, subgroup analysis, and evaluated publication bias. A total of 17 studies were included, including seven on blood Cd and 10 on urine Cd. By combining the odds ratio (OR) and 95% confidence interval (CI) for the lowest and highest categories, the odds ratio of blood Cd concentration that increased the risk of osteoporosis or osteopenia was OR 1.21 (95% CI: 0.84-1.58) and that of urine Cd concentration that increased the risk of osteoporosis or osteopenia was OR 1.80 (95% CI: 1.42-2.18), and the results of the subgroup analysis were also consistent. Our research indicates that while urine cadmium (Cd) concentration may be related to increased risk of osteoporosis and osteopenia, blood Cd concentration may not. Therefore, compared to blood Cd concentration, urine Cd concentration may be more reliable as a risk factor for osteoporosis and osteopenia. This result should be interpreted with caution. Currently. research on the relationship between Cd concentration and osteoporosis and osteopenia is limited, thus, further large, high-quality prospective studies are required to elucidate the relationship between Cd concentration and osteoporosis and osteopenia.
随着社会老龄化，骨质疏松症的发病率增加。在多项研究中，镉（Cd）被认为与骨质疏松症有关。然而，关于镉与骨质疏松症和骨质减少风险之间的关系，存在相互矛盾的报道。因此，本荟萃分析的目的是探讨镉与骨质疏松症和骨质减少之间的关系。通过文献回顾，确定了截至2020年12月在PubMed上发表的文章，并对相关出版物和综述的参考文献进行了审查。最终，选择了17篇符合条件的文章来确定血液和尿液中镉浓度与骨质疏松症或骨质减少风险之间的关系。在本研究中，我们进行了分类分析、异质性检验、亚组分析，并评估了发表偏倚。共纳入17项研究，其中7项关于血液镉，10项关于尿液镉。通过合并最低和最高类别组的比值比（OR）和95%置信区间（CI），血液镉浓度增加骨质疏松症或骨质减少风险的比值比为OR 1.21（95%CI：0.84-1.58），尿液镉浓度增加骨质疏松症或骨质减少风险的比值比为OR 1.80（95%CI：1.42-2.18），亚组分析结果也一致。我们的研究表明，虽然尿液镉（Cd）浓度可能与骨质疏松症和骨质减少风险增加有关，但血液镉浓度可能无关。因此，与血液镉浓度相比，尿液镉浓度作为骨质疏松症和骨质减少的风险因素可能更可靠。该结果应谨慎解读。目前，关于镉浓度与骨质疏松症和骨质减少之间关系的研究有限，因此，需要进一步开展大规模、高质量的前瞻性研究来阐明镉浓度与骨质疏松症和骨质减少之间的关系。
