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The association between hemoglobin level and osteoporosis in a Chinese population with environmental lead and cadmium exposure

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Abstract

Low hemoglobin (Hb) level or anemia is associated with osteoporosis and bone fracture. Cadmium (Cd) and lead (Pb) exposure are also risk factors of osteoporosis and anemia. However, the role of anemia in Cd/Pb related bone loss remains unclear. The aim of present study was to investigate the association between Hb level and bone loss in a population with environmental lead and cadmium exposure. One hundred and ninety-four women and 108 men with different levels of Cd/Pb exposure were included in our study. The Cd/Pb exposure was determined using graphite-furnace atomic absorption spectrometry. Forearm bone mineral density (BMD) was determined by peripheral dual-energy X-ray absortiometry. Hb concentration was determined using an automatic blood cellcounter. A logistic model was established to predict the risk of osteoporosis. The BMDs of women that had the highest quartile BCd and BPb were markedly lower than that with the lowest quartile (p < 0.05). The BMD and the prevalence of osteoporosis in men with anemia were lower and higher than that with normal Hb (p < 0.05), respectively. In men, age, BPb and anemia were independent risk factors for osteoporosis. The odds ratio (OR) of men with anemia was 11.28 (95%confidence interval (CI):1.94-65.54) and 19.56 (95%CI: 2.98-128.78) compared to those with normal Hb after adjusting for potential cofounders. No such association was found in women. The area under the curve was 0.88 (95%CI: 0.82-0.96) in predicting osteoporosis using the logistic model in men. Linear discriminant analysis also showed that 90.7% of osteoporosis was correctly classified. Our data show that anemia is associated with incident of osteoporosis in men but not in women that environmentally exposed to Pb and Cd.

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Data availability

Data or materials used in the study are available from the corresponding author by request.

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Acknowledgements

This study was funded by National Natural Science foundation of China (No. 81773460, 81102148) and Natural Science Foundation of Jiangsu Province (no. BK20161609).

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Authors and Affiliations

  1. Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China

    Miaomiao Wang, Xinru Wang, Wenjing Cui & Xiao Chen

  2. Institute of Radiation Medicine, Fudan University, 2094 Xietu road, Shanghai, 200032, China

    Guoying Zhu

  3. Department of Occupational Medicine, School of Public Health, Shanghai Medical College of Fudan University, 150 Dongan road, Shanghai, 200032, China

    Yihuai Liang & Taiyi Jin

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  1. Miaomiao Wang
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  2. Xinru Wang
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Correspondence to Xiao Chen or Taiyi Jin.

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Wang, M., Wang, X., Cui, W. et al. The association between hemoglobin level and osteoporosis in a Chinese population with environmental lead and cadmium exposure. Environ Geochem Health 44, 1673–1682 (2022). https://doi.org/10.1007/s10653-021-01129-0

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