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Relatively low fluoride in drinking water increases risk of knee osteoarthritis (KOA): a population-based cross-sectional study in China

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Abstract

Previous studies indicate that fluoride in drinking water has a toxic effect on cartilage and skeleton, which triggers osteoarthritis (OA) of which the most frequent is knee OA (KOA). A cross-sectional study was conducted to assess the association between fluoride exposure and KOA among 1128 subjects. Water fluoride (WF) and urinary fluoride (UF) were chosen as external exposure (internal exposure) of fluoride. Logistic regression analysis showed that an increased fluoride exposure was a risk factor for KOA (WF: OR = 1.318, 95% CI 1.162–1.495, p < 0.001; UF: OR = 1.210, 95% CI 1.119–1.310, p < 0.001). After adjusting for covariates, the risk of KOA in the 4th quartile (Q) of WF was twice that of the 1st Q (OR = 2.079, 95% CI 1.448–2.986, p < 0.001). The risks of KOA in the 2nd Q, 3rd Q and 4th Q of UF were 1.6, 1.5, and 2.9 times higher than in the 1stQ (OR = 1.597, 95% CI 1.066–2.393, p = 0.023; OR = 1.560, 95% CI 1.043–2.333, p = 0.030; OR = 2.897, 95% CI 1.957–4.288, p < 0.001). The population aged < 60 exposed to the 4th Q of WF (or UF) had a higher risk than the population exposed to the 1st Q of WF (or UF) (ORWF = 1.958, 95% CI 1.249–3.070, p = 0.003; ORUF = 2.923, 95% CI 1.814–4.711, p < 0.001). With increasing UF by Q, the male had a risk of KOA. In conclusion, excessive fluoride dose in drinking water could increase the risk of KOA. Especially, the population with aged < 60, male and obesity more likely to having KOA when they exposed to same higher fluoride.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank the residents of Suihua city, Daqing city and Qiqihar city, especially those participants that have been included in this study. We are grateful to the authorities of those cities and of the local Center of Endemic Disease Controls for their supports and assistance.

Funding

This study was supported by National Natural Science Foundation of China (82273749, 81773468, and No. U1812403) and the National Key R&D Program of China (2022YFC2503000).

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  1. Xinyue Meng and Jian Wang have contributed equally to this work

Authors and Affiliations

  1. Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China

    Xinyue Meng, Jian Wang, Yang Liu, Mang Li, Alphonse Sowanoua, Junrui Pei & Yanhui Gao

  2. Department of Pathology and Key Lab of Endemic and Ethnic Diseases, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou Province, China

    Zhizhong Guan

  3. Chongqing Blood Center, Jiulongpo, 400015, Chongqing, China

    Dan Yang

  4. Chongqing, China

    Dan Yang

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  1. Xinyue Meng
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Contributions

Conceived and designed the experiments: JP and YG. Performed the experiments: XM, JW, YL, ML, ZG, AS, JP, DY and YG. Contributed reagents/materials/analysis tools: JP and DY. Wrote the paper: JP, XM, JW, YL, ML and ZG. XM and JW contributed equally to this work.

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Correspondence to Dan Yang, Junrui Pei or Yanhui Gao.

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Meng, X., Wang, J., Liu, Y. et al. Relatively low fluoride in drinking water increases risk of knee osteoarthritis (KOA): a population-based cross-sectional study in China. Environ Geochem Health 45, 8735–8747 (2023). https://doi.org/10.1007/s10653-023-01742-1

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