SEARCHCROSS-SECTIONALepidemiology, public health

cross-sectional·epidemiology, public health, geriatrics, endocrinology, observational study·PMC10043376

Relationship of blood heavy metals and osteoporosis among the middle-aged and elderly adults: A secondary analysis from NHANES 2013 to 2014 and 2017 to 2018

Frontiers in Public Health · 6 authors, 3 centres

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TL;DR

This secondary analysis of NHANES data examined associations between blood heavy metal levels and osteoporosis in 1,777 US middle-aged and elderly adults. The study found that higher blood cadmium levels were associated with a greater prevalence of osteoporosis, while higher blood selenium levels were associated with a lower prevalence.

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This cross-sectional study analyzed data from 1,777 middle-aged and elderly participants in NHANES (2013–2014 and 2017–2018). Researchers used logistic regression and weighted quantile sum regression to assess relationships between blood levels of five heavy metals (cadmium, selenium, lead, mercury, manganese) and osteoporosis prevalence. After adjustment, a significant positive association was found between blood cadmium and osteoporosis, with odds ratios increasing across quartiles (e.g., quartile 4 OR=15.64). Conversely, the highest quartile of blood selenium was associated with a lower prevalence (OR=0.34). Lead, mercury, and manganese showed no statistically significant overall association. Subgroup analyses indicated the cadmium association was significant in women and non-smokers, while selenium's protective association was found in both sexes and smoking subgroups.

STUDY TYPE

cross-sectional

SPECIALTY

epidemiology

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ORIGINAL PAPER

PMC10043376

Relationship of blood heavy metals and osteoporosis among the middle-aged and elderly adults: A secondary analysis from NHANES 2013 to 2014 and 2017 to 2018

Frontiers in Public Health

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ABSTRACT

Abstract Objective This study aimed to assess the relationship between blood heavy metals and a higher prevalence of osteoporosis in middle-aged and elderly US adults using the National Health and Nutritional Examination Surveys (NHANES). Methods The secondary data analysis was performed using the data of NHANES 2013–2014 and 2017–2018. We used the information, including physical examination, laboratory tests, questionnaires, and interviews, provided by participants in NHANES. Logistic regression and weighted quantile sum (WQS) regression models were used to explore the relationships between levels of blood heavy metals and a higher prevalence of osteoporosis. Results A total of 1,777 middle-aged and elderly participants were analyzed in this study, comprising 115 participants with osteoporosis and 1,662 without osteoporosis. Adjusted model 1 showed a significant positive relationship between cadmium (Cd) levels and a higher prevalence of osteoporosis (quartile 2, OR = 7.62; 95% CI, 2.01–29.03; p = 0.003; quartile 3, OR = 12.38; 95% CI, 3.88–39.60; p < 0.001; and quartile 4, OR = 15.64; 95% CI, 3.22–76.08; p = 0.001). The fourth quartile of selenium (Se) level (OR = 0.34; 95% CI, 0.14–0.39; p < 0.001) led to a lower prevalence of osteoporosis and exerted a protective effect on model 1. Other models produced similar results to those of model 1. A subgroup analysis showed that Cd levels were positively related to a higher prevalence of osteoporosis in all three models in women, while this relationship was not found in men. The fourth quartile of the Se level was related to a lower prevalence of osteoporosis in both male and female analyses. A significant positive relationship was found between the blood Cd level and a higher prevalence of osteoporosis in the non-smoking subgroup. Blood Se level showed a protective effect on the fourth quartile in both the smoking and non-smoking subgroups. Conclusion Blood Cd level aggravated the prevalence of osteoporosis, while blood Se level could be a protective factor in osteoporosis among the US middle-aged and older populations. Keywords: osteoporosis, heavy metals, NHANES, risk factors, middle-aged and older population

CITATION EXPORT

Zengfa Huang, Xiang Wang, Hui Wang et al.. Relationship of blood heavy metals and osteoporosis among the middle-aged and elderly adults: A secondary analysis from NHANES 2013 to 2014 and 2017 to 2018. Frontiers in Public Health. (2023). https://doi.org/10.3389/fpubh.2023.1045020

AUTHORS

6 · 3 CENTRES

Zengfa Huang, Xiang Wang, Hui Wang, Shutong Zhang, Xinyu Du, Hui Wei

1Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
2Department of Radiology, The Central Hospital of Wuhan Base, Hubei University of Medicine, Shiyan, Hubei, China
3Department of Orthopedics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China