Early-Life Cadmium Exposure and Bone-Related Biomarkers: A Longitudinal Study in Children

Environ Health Perspect. 2019 Mar;127(3):37003. doi: 10.1289/EHP3655.


Background: Chronic cadmium exposure has been associated with osteotoxicity in adults, but little is known concerning its effects on early growth, which has been shown to be impaired by cadmium.

Objectives: Our objective was to assess the impact of early-life cadmium exposure on bone-related biomarkers and anthropometry at 9 y of age.

Methods: For 504 children in a mother-child cohort in Bangladesh, cadmium exposure was assessed by concentrations in urine (U-Cd, long-term exposure) and erythrocytes (Ery-Cd, ongoing exposure) at 9 and 4.5 y of age, and in their mothers during pregnancy. Biomarkers of bone remodeling [urinary deoxypyridinoline (DPD), urinary calcium, plasma parathyroid hormone, osteocalcin, vitamin D3, insulin-like growth factor (IGF) 1, IGF binding protein 3, thyroid stimulating hormone] were measured at 9 y of age.

Results: In multivariable-adjusted linear models, a doubling of concurrent U-Cd was associated with a mean increase in osteocalcin of [Formula: see text] (95% CI: 0.042, 5.9) and in urinary DPD of [Formula: see text] (95% CI: 12, 32). In a combined exposure model, a doubling of maternal Ery-Cd was associated with a mean increase in urinary DPD of [Formula: see text] (95% CI: [Formula: see text], 30). Stratifying the osteocalcin model by gender ([Formula: see text] 0.001), a doubling of concurrent U-Cd was associated with a mean decrease in osteocalcin of [Formula: see text] (95% CI: [Formula: see text], [Formula: see text]) in boys and a mean increase of [Formula: see text] (95% CI: 5.4, 13) in girls. The same pattern was seen with U-Cd at 4.5 y of age ([Formula: see text] 0.016). Children's U-Cd and Ery-Cd, concurrent and at 4.5 y of age, were inversely associated with vitamin D3.

Conclusions: Childhood cadmium exposure was associated with several bone-related biomarkers and some of the associations differed by gender. https://doi.org/10.1289/EHP3655.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Bangladesh
  • Biomarkers / analysis*
  • Bone and Bones / chemistry*
  • Cadmium / adverse effects*
  • Child
  • Environmental Exposure / adverse effects*
  • Environmental Pollutants / adverse effects*
  • Female
  • Humans
  • Longitudinal Studies
  • Pregnancy
  • Prenatal Exposure Delayed Effects / chemically induced
  • Prenatal Exposure Delayed Effects / epidemiology*


  • Biomarkers
  • Environmental Pollutants
  • Cadmium