Abstract
Many essential/beneficial elements including Ca, Mg, Sr, B, and F− play an important role in bone health. While elevated levels of F− are known to cause adverse health effects on bone, variations of these elements in nails that can be influenced by F− toxicity are unclear. This study aims to assess the relationship between the concentrations of Ca, Mg, Sr, and B in fingernails and bone quality of F−exposed individuals in the Ethiopian Rift Valley. Bone quality was determined using an ultrasonic method that measures the magnitude of speed of sound (SOS) conduction in cortical bones. We collected fingernails of individuals aged 10 to 70 years old (144 males and 123 females) in 25 communities drinking water from wells with F− concentrations ranging from 0.3 to 15.5 mg/L (mean 7 ± 4.7 mg/L). Fluoride concentrations in drinking water were measured using the ion selective electrode (ISE) method. Concentrations of Ca, Mg, Sr, and B in fingernails were measured using Inductively Coupled Plasma Spectrometry (ICP-MS). Mean Ca, Mg, Sr, and B concentrations (mg/kg) in fingernails were 740 ± 425, 98 ± 89, 1.33 ± 1.6, and 0.63 ± 1.2, respectively. Each element was categorized by F− concentrations (mg/L) in drinking water as groups: 1 (< 2), 2 (> 2–6), 3 (> 6–10), and 4 (> 10–15.5). The mean concentrations of these elements in fingernails increased with the increase in F− concentrations in drinking water, and significant differences were observed in the means of groups 1 and 4 for all elements, group 2 for Sr, and group 3 for B. The correlation trends for SOS measurements with these elements in fingernails at different age groups decrease with high F− exposure and the negative associations are more pronounced at older (51–70) ages. These associations suggest F−related bone deterioration in the studied subjects, which is noticeable with the increase in age. The study demonstrates the effect of F− exposure on bone quality, and the studied fingernail elemental variations in populations chronically exposed to F− in drinking water.
Similar content being viewed by others
Data Availability
Enquiries about data availability should be directed to the authors.
References
Anupama DS, Norohna JA, Acharya KK, Ravishankar, George A (2020) Effect of exercise on bone mineral density and quality of life among postmenopausal women with osteoporosis without fracture: a systematic review. Int J Orthop Trauma Nurs 39:100796. https://doi.org/10.1016/j.ijotn.2020.100796
Bonetto SMR, Caselle C, De Luca DA, Lasagna M (2021) Groundwater resources in the Main Ethiopian Rift Valley: an overview for a sustainable development. Sustainability 13(3):1347. https://doi.org/10.3390/su13031347
Cabrera WE, Schrooten I, Broe MED, D’Haese PC (1999) Strontium and bone. J Bone Miner Res 14(5):661–668. https://doi.org/10.1359/jbmr.1999.14.5.661
Cao J, Zhao Y, Liu J, Xirao R, Danzeng S, Daji D, Yan Y (2003) Brick tea fluoride as a main source of adult fluorosis. Food Chem Toxicol 41(4):535–542. https://doi.org/10.1016/s0278-6915(02)00285-5
Campion JM, Maricic MJ (2003) Osteoporosis in men. Am Fam Physician 67(7):1521–1526
Cashman MW, Sloan SB (2010) Nutrition and nail disease. Clin Dermatol 28(4):420–425. https://doi.org/10.1016/j.clindermatol.2010.03.037
Castiglioni S, Cazzaniga A, Albisetti W, Maier JA (2013) Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients 5(8):3022–3033. https://doi.org/10.3390/nu5083022
Centers for Disease Control and Prevention (2006) Water fluoridation. Division of oral health. Retrieved March 15, 2022, from https://www.cdc.gov/fluoridation/pdf/natures_way.pdf
Ciosek Ż, Kot K, Kosik-Bogacka D, Łanocha-Arendarczyk N, Rotter I (2021) The effects of calcium, magnesium, phosphorus, fluoride, and lead on bone tissue. Biomolecules 11(4):506. https://doi.org/10.3390/biom11040506
Davies JH, Evans BAJ, Gregory JW (2005) Bone mass acquisition in healthy children. Arch Dis Child 90(4):373–378. https://doi.org/10.1136/adc.2004.053553
Demelash H, Beyene A, Abebe Z, Melese A (2019) Fluoride concentration in ground water and prevalence of dental fluorosis in Ethiopian Rift Valley: systematic review and meta-analysis. BMC Public Health 19(1):1298. https://doi.org/10.1186/s12889-019-7646-8
Edmunds WM, Smedley PL (2013) Fluoride in natural waters. In: Selinus O (ed) Essentials of medical geology. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-4375-5_13
Ethiopian Standards Agency (2013) Compulsory Ethiopian standard: drinking water- specifications (CES 58). Retrieved March 15, 2022, from https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/drinking_water_specifications.pdf
Everett ET (2011) Fluoride’s effects on the formation of teeth and bones, and the influence of genetics. J Dent Res 90(5):552–560. https://doi.org/10.1177/0022034510384626
Gaffney-Stomberg E (2019) The impact of trace minerals on bone metabolism. Biol Trace Elem Res 188(1):26–34. https://doi.org/10.1007/s12011-018-1583-8
Genius S, Bouchard T (2012) Combination of micronutrients of bone (COMB) study: bone density after micronutrient intervention. J Environ Public Health 2012:1–10. https://doi.org/10.1155/2012/354151
Hakki SS, Dundar N, Kayis SA, Hakki EE, Hamurcu M, Kerimoglu U, Baspinar N, Basoglu A, Nielsen FH (2013) Boron enhances strength and alters mineral composition of bone in rabbits fed a high energy diet. J Trace Elem Med Biol 27(2):148–153. https://doi.org/10.1016/j.jtemb.2012.07.001
Helte E, Donat VC, Kippler M, Wolk A, Michaëlsson K, Åkesson A (2021) Fluoride in drinking water, diet, and urine in relation to bone mineral density and fracture incidence in postmenopausal women. Environ Health Perspect 129(4):047005. https://doi.org/10.1289/EHP7404
IOM (Institute of Medicine) (1997) Dietary reference intakes: for calcium, phosphorus, magnesium, vitamin D, and fluoride. National Academy Press, Washington, DC
Kaufman J, Einhorn T (1993) Perspectives: ultrasound assessment of bone. J Bone Miner Res 8:517–525
Laurent MR, Dedeyne L, Dupont J, Mellaerts B, Dejaeger M, Gielen E (2019) Age-related bone loss and sarcopenia in men. Maturitas 122:51–56. https://doi.org/10.1016/j.maturitas.2019.01.006
Lane JM, Russell L, Khan SN (2000) Osteoporosis. Clin Orthop Relat Res 372:139–150. https://doi.org/10.1097/00003086-200003000-00016
Levy SM, Warren JJ, Phipps K, Letuchy E, Broffitt B, Eichenberger-Gilmore J, Burns TL, Kavand G, Janz KF, Torner JC, Pauley CA (2014) Effects of life-long fluoride intake on bone measures of adolescents: a prospective cohort study. J Dent Res 93(4):353–359. https://doi.org/10.1177/0022034514520708
Li Y, Liang C, Slemenda CW, Ji R, Sun S, Cao J, Emsley CL, Ma F, Wu Y, Ying P, Zhang Y, Gao S, Zhang W, Katz BP, Niu S, Cao S, Johnston CC Jr (2001) Effect of long-term exposure to fluoride in drinking water on risks of bone fractures. J Bone Min Res 16(5):932–939. https://doi.org/10.1359/jbmr.2001.16.5.932
Matkovic V, Jelic T, Wardlaw GM, Ilich JZ, Goel PK, Wright JK, Andon MB, Smith KT, Heaney RP (1994) Timing of peak bone mass in Caucasian females and its implication for the prevention of osteoporosis. Inference from a cross-sectional model. J Clin Investig 93(2):799–808. https://doi.org/10.1172/JCI117034
Mehta SS, Oz OK, Antich PP (1998) Bone elasticity and ultrasound velocity are affected by subtle changes in the organic matrix. J Bone Min Res 13(1):114–121. https://doi.org/10.1359/jbmr.1998.13.1.114
Mehta SS, Antich PP, Daphtary MM, Bronson DG, Richer E (2001) Bone material ultrasound velocity is predictive of whole bone strength. Ultrasound Med Biol 27(6):861–867. https://doi.org/10.1016/S0301-5629(01)00385-4
Mutimura E, Shi Q, Hoover DR, Anastos K, Rudakemwa E, Dusingize JC, Sinabye JD, Yin MT (2016) Bone quality assessed using quantitative ultrasound at the distal radius does not differ in antiretroviral therapy-naïve HIV-positive and HIV-negative Rwandan women. HIV Med 17(10):724–727. https://doi.org/10.1111/hiv.12376
National Institute of Health (2021) Boron. U.S. Department of Health & Human Services. Retrieved March 15, 2022, from https://ods.od.nih.gov/factsheets/Boron-HealthProfessional/
National Research Council (2006) Fluoride in drinking water: a scientific review of EPA’s standards. The National Academies Press. https://doi.org/10.17226/11571
Nicole W (2021) Denser but not stronger? Fluoride-induced bone growth and increased risk of hip fractures. Environ Health Perspect 129(7):074001. https://doi.org/10.1289/EHP9533
Nyachoti S, Adebayo S, Godebo TR (2021) Elemental composition of teff (a gluten-free grain), maize and wheat: staple crops in the Main Ethiopian Rift Valley. J Food Compos Anal 100:103660. https://doi.org/10.1016/j.jfca.2020.103660
Ohgitani S, Fujita T, Fujii Y, Hayashi C, Nishio H (2005) Nail calcium and magnesium content in relation to age and bone mineral density. J Bone Miner Metab 23(4):318–322. https://doi.org/10.1007/s00774-005-0606-7
Palacios C (2006) The role of nutrients in bone health, from A to Z. Crit Rev Food Sci Nutr 46(8):621–628. https://doi.org/10.1080/10408390500466174
Phipps K (1995) Fluoride and bone health. J Public Health Dent 55(1):53–56. https://doi.org/10.1111/j.1752-7325.1995.tb02331.x
Pizzorno L (2015) Nothing boring about boron. Integr Med (encinitas, Calif.) 14(4):35–48
Ponikvar M (2008) Exposure of humans to fluorine and its assessment. In: Tressaud A (ed) Fluorine and health. Elsevier, Amsterdam, pp 487–549. https://doi.org/10.1016/B978-0-444-53086-8.00012-6
Price CT, Langford JR, Liporace FA (2012) Essential nutrients for bone health and a review of their availability in the average north American diet. Open Orthop J 6:143–149. https://doi.org/10.2174/1874325001206010143
Querido W, Rossi AL, Farina M (2016) The effects of strontium on bone mineral: a review on current knowledge and microanalytical approaches. Micron (oxford, England: 1993) 80:122–134. https://doi.org/10.1016/j.micron.2015.10.006
Rango T, Kravchenko J, Atlaw B, McCornick PG, Jeuland M, Merola B, Vengosh A (2012) Groundwater quality and its health impact: an assessment of dental fluorosis in rural inhabitants of the Main Ethiopian Rift. Environ Int 43:37–47. https://doi.org/10.1016/j.envint.2012.03.002
Rango T, Vengosh A, Jeuland M, Tekle-Haimanot R, Weinthal E, Kravchenko J, Paul C, McCornick P (2014) Fluoride exposure from groundwater as reflected by urinary fluoride and children’s dental fluorosis in the Main Ethiopian Rift Valley. Sci Total Environ 496:188–197. https://doi.org/10.1016/j.scitotenv.2014.07.048
Rango T, Vengosh A, Jeuland M, Whitford GM, Tekle-Haimanot R (2017) Biomarkers of chronic fluoride exposure in groundwater in a highly exposed population. Sci Total Environ 596–597:1–11. https://doi.org/10.1016/j.scitotenv.2017.04.021
Rango TR, Jeuland M, Tekle-Haimanot R, Shankar A, Alemayehu B, Assefa G, Whitford G, Wolfe A (2020) Bone quality in fluoride-exposed populations: a novel application of the ultrasonic method. Bone Rep 12:100235. https://doi.org/10.1016/j.bonr.2019.100235
Raum K, Grimal Q, Varga P, Barkmann R, Glüer CC, Laugier P (2014) Ultrasound to assess bone quality. Curr Osteoporos Rep 12(2):154–162. https://doi.org/10.1007/s11914-014-0205-4
Rezaee T, Bouxsein ML, Karim L (2020) Increasing fluoride content deteriorates rat bone mechanical properties. Bone 136:115369. https://doi.org/10.1016/j.bone.2020.115369
Rivas-Ruiz R, Clark P, Talavera JO, Huitrón G, Tamayo JA, Salmerón J (2015) Bone speed of sound throughout lifetime assessed with quantitative ultrasound in a Mexican population. J Clin Densitom 18(1):68–75. https://doi.org/10.1016/j.jocd.2013.11.002
Rizzoli R, Bianchi ML, Garabédian M, McKay HA, Moreno LA (2010) Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone 46(2):294–305. https://doi.org/10.1016/j.bone.2009.10.005
Saeedi P, Shavandi A, Meredith-Jones K (2018) Nail properties and bone health: a review. J Funct Biomater 9(2):31. https://doi.org/10.3390/jfb9020031
Sievänen H, Cheng S, Ollikainen S, Uusi-Rasi K (2001) Ultrasound velocity and cortical bone characteristics in vivo. Osteoporos Int 12(5):399–405. https://doi.org/10.1007/s001980170109
Simon MJK, Beil FT, Rüther W, Busse B, Koehne T, Steiner M, Pogoda P, Ignatius A, Amling M, Oheim R (2014) High fluoride and low calcium levels in drinking water is associated with low bone mass, reduced bone quality and fragility fractures in sheep. Osteoporos Int 25(7):1891–1903. https://doi.org/10.1007/s00198-014-2707-4
Sowers M, Whitford GM, Clark MK, Jannausch ML (2005) Elevated serum fluoride concentrations in women are not related to fractures and bone mineral density. J Nutr 135(9):2247–2252. https://doi.org/10.1093/jn/135.9.2247
Vidyadharan M, Issac JS, Joseph AM, Joseph A, John D, Varadharaju VK (2020) Comparative evaluation of hair, fingernails, and toenails as biomarkers of fluoride exposure: a cross-sectional study. J Int Soc Prev Community Dent 10(3):269–278. https://doi.org/10.4103/jispcd.JISPCD_52_20
Vignolo M, Parodi A, Mascagni A, Torrisi C, De Terlizzi F, Aicardi G (2006) Longitudinal assessment of bone quality by quantitative ultrasonography in children and adolescents. Ultrasound Med Biol 32(7):1003–1010. https://doi.org/10.1016/j.ultrasmedbio.2006.02.1429
Vondracek SF, Linnebur SA (2009) Diagnosis and management of osteoporosis in the older senior. Clin Interv Aging 4:121–136. https://doi.org/10.2147/CIA.S4965
Wang L, Yu H, Yang G, Zhang Y, Wang W, Su T, Ma W, Yang F, Chen L, He L, Ma Y, Zhang Y (2015) Correlation between bone mineral density and serum trace element contents of elderly males in Beijing urban area. Int J Clin Exp Med 8(10):19250–19257
Whitford GM (1994) Intake and metabolism of fluoride. Adv Dent Res 8(1):5–14. https://doi.org/10.1177/08959374940080011001
WHO (2016) The public health impact of chemicals: knowns and unknowns. WHO/ International Programme on Chemical Safety, Geneva
Yesil Y, Kuyumcu ME, Ozturk ZA, Ulger Z, Sahin U, Cankurtaran M, Halil M, Yavuz BB, Vural H, Kara Y, Demirin H, Akyol O, Ariogul S (2012) The relationship between metabolic bone diseases and fingernail calcium levels in the elderly. Eur Geriatr Med 3(6):341–344. https://doi.org/10.1016/j.eurger.2012.07.458
Zhu F (2018) Chemical composition and food uses of teff (Eragrostis tef). Food Chem 239:402–415. https://doi.org/10.1016/j.foodchem.2017.06.101
Zofkova I, Davis M, Blahos J (2017) Trace elements have beneficial, as well as detrimental effects on bone homeostasis. Physiol Res. https://doi.org/10.33549/physiolres.933454
Funding
Funding was provided by National Institute of Environmental Health Sciences’s career development grant (K99/R00 ES023472).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Kodsup, P., Godebo, T.R. & Nyachoti, S. Associations Between Essential Elements in Fingernails and Bone Quality in Populations Exposed to Chronic Fluoride in Drinking Water. Expo Health 14, 475–485 (2022). https://doi.org/10.1007/s12403-022-00474-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12403-022-00474-4