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Associations of multiple plasma metals with osteoporosis: findings from the Dongfeng-Tongji cohort

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Abstract

With the aging population, osteoporosis has become a more prevalent public health issue. Existing researches have indicated significant relations of single metal exposure with osteoporosis (e.g., lead, copper, and zinc), whereas the evidence regarding the joint association of metal mixtures with osteoporosis remain limited and inconclusive. A total of 4924 participants from the Dongfeng-Tongji cohort were included in the present study. Plasma levels of 23 metals were determined by inductively coupled plasma mass spectrometry, and the presence of osteoporosis was defined as a bone mineral density T-score ≤  − 2.5. We applied stepwise regression, plasma metal score, and quantile g-computation model to evaluate the association between plasma metal mixtures and osteoporosis risk. Of the 4924 participants, the prevalence of osteoporosis was 10.9% (N = 265) in males and 27.5% (N = 684) in females. In the multiple-metals model, arsenic was positively associated with osteoporosis in males, while zinc was positively associated with osteoporosis in females. Comparing extreme quartiles, the multivariate-adjusted ORs of osteoporosis were 2.20 (95% CI, 1.29, 3.79; P-trend = 0.006) for arsenic in males and 2.16 (95% CI, 1.44, 3.23; P-trend < 0.001) for zinc in females. The plasma metal score was significantly and positively associated with a higher risk of osteoporosis, with ORs (95% CI) comparing extreme quartiles were 5.00 (95% CI, 3.36, 7.65; P-trend < 0.001) in males and 1.76 (95% CI, 1.35, 2.29; P-trend < 0.001) in females. Furthermore, the results of quantile g-computation revealed a consistent positive trend of metal mixtures with risk of osteoporosis and suggested the dominant role of arsenic in males and zinc in females, respectively. Our findings highlighted the importance of controlling metal mixtures exposure for the prevention of osteoporosis in the middle-aged and elder population. Further prospective studies in larger populations are warranted to confirm our findings.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We thank all study participants, researchers, and students who participated in the present study.

Funding

This work was supported by the National Natural Science Foundation of China (81930092, 82003428, 82021005, 82192903), the Foundation of the National Key Research and Development Program of China (2016YFC0900800), the Fundamental Research Funds for the Central Universities, HUST (2019kfyXMBZ015, 2021XXJS019).

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XX: conceptualization, formal analysis, methodology, and writing—original draft. JL: methodology and writing—review and editing. PL: investigation. KL: Investigation. HW: investigation. XW: investigation. YY: investigation. HY: data curation. XZ: investigation. HG: investigation. MH: data curation and project administration. TW: conceptualization, funding acquisition, data curation, and supervision. YY: conceptualization, funding acquisition, investigation, data curation, writing—review and editing—and supervision.

Corresponding author

Correspondence to Yu Yuan.

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The study protocol was agreed upon by the institution of Medical Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology and Dongfeng General Hospital.

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All participants provided written informed consent.

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All enrolled subjects signed informed consent regarding publishing their data.

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The authors declare no competing interests.

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Responsible Editor: Lotfi Aleya

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Xu, X., Lyu, J., Long, P. et al. Associations of multiple plasma metals with osteoporosis: findings from the Dongfeng-Tongji cohort. Environ Sci Pollut Res 30, 120903–120914 (2023). https://doi.org/10.1007/s11356-023-30816-x

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  • DOI: https://doi.org/10.1007/s11356-023-30816-x

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