Association of blood heavy metal levels with osteocalcin abnormality and incidence of osteoporosis in Saudi subjects

Plasma heavy metal levels correlate with deregulated gene expression of detoxifying enzymes in osteoporotic patients

Heavy metal levels appear to be associated with low bone mineral density (BMD) and the consequent osteoporosis risk, but the relationship with the disease has not been clearly defined. The altered expression pattern of numerous genes, including detoxifying genes, seems to play a pivotal role in this context, leading to increased susceptibility to several diseases, including osteoporosis. The purpose of this study is to analyse circulating heavy metals levels and the expression of detoxifying genes in osteoporotic patients (OPs, n = 31), compared with healthy subjects (CTRs, n = 32). Heavy metals concentration in plasma samples was determined by Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and the subsequent expression analysis of NAD(P)H quinone dehydrogenase 1 (NQO1), Catalase (CAT), and Metallothionein 1E (MT1E) genes in Peripheral Blood Mononuclear Cells (PBMCs) was assessed by real-time polymerase chain reaction (qRT-PCR). Copper (Cu), mercury (Hg), molybdenum (Mo) and lead (Pb) were found to be significantly higher in the plasma of OPs compared to CTRs. Analysis of the expression levels of detoxifying genes showed a significant decrease in CAT and MT1E in OP group. In addition, Cu correlated positively with the expression levels of both CAT and MT1E in CTRs group and MT1E in OPs. This study shows an increased circulating concentration of certain metals combined with an altered expression pattern of detoxifying genes in OPs, highlighting a novel aspect to be investigated in order to better characterize the role of metals in the pathogenesis of osteoporosis.

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

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.

Race and Gender Differences in the Associations Between Cadmium Exposure and Bone Mineral Density in US Adults

Several previous studies have found the deleterious effects of cadmium exposure on bone. However, studies on the effects of cadmium exposure on bone mineral density (BMD) in gender- and race-specific groups are still lacking. The aim of this study was to investigate the relationship between cadmium exposure and BMD in adults and the gender and racial differences therein. Weighted multivariate regression, generalized weighted model, and smoothed curve fitting were used to explore the relationship between lumbar BMD with blood cadmium (B-Cd) and urine cadmium (U-Cd) based on data from the National Health and Nutrition Examination Survey (NHANES). In addition, subgroup analyses were further used to investigate the differential associations across gender and race. Of the 4335 adult participants. After adjusting for primary demographic variables, B-Cd [- 0.018 (- 0.028, - 0.008)] and U-Cd [- 0.010 (- 0.020, - 0.001)] were shown to be negatively related to lumbar BMD. In the fully adjusted model, the negative association between B-Cd and lumbar BMD was maintained [- 0.010 (- 0.018, - 0.002)]. In the subgroup analysis stratified by gender and race, this relationship was retained in females and non-Hispanic blacks. Furthermore, these negative associations were most pronounced among non-Hispanic black women [B-Cd and lumbar BMD, - 0.046 (- 0.076, - 0.017); U-Cd and lumbar BMD, -0.034 (- 0.063, - 0.006)]. Our findings suggest that there are significant sex and race differences in the negative association between cadmium exposure and BMD. This negative association was most prominent in non-Hispanic black females.

Potential ecological risk assessment of heavy metals (trace elements) in coastal soils of southwest Iran

Heavy metal pollution has become one of the most important threats that can endanger the health of animals, the environment, and humans. The present study was performed to investigate the potential ecological risk (PER) of heavy metals [zinc (Zn), copper (Cu), cobalt (Co), molybdenum (Mo), manganese (Mn), and selenium (Se)] in the coastal soils of southwest Iran in 2019. The samples were collected from six soil sites and three depth intervals (0-15, 15-30, and 30-45 cm) among bare and vegetated coastal soils. The soil samples to study the soil properties (soil grain size, pH, EC, and soil organic carbon) and metal contamination were taken from soil (36 samples), water (6 samples), and plants (24 samples). The soil ecological risk (ER), the pollution load index (PLI), contamination degree (Cdeg), modified contamination degree (mCdeg) for heavy metal contamination in the soil, and enrichment factor (EF index) indicate the origin of metals entering the environment, and hence these parameters were investigated. The results of this study showed that the levels of Zn, Cu, Co, Mn, Se, and Mo were in the range of low-risk contaminants in this region. According to the results of the study, the risk index (RI) for metals was in the range of 1.296-3.845, which is much lower than 150, and therefore the ecological risk potential calculated in this study was in the low-risk category for toxic elements. Based on the results, it was found that agricultural, industrial, and human activities played an effective role in the accumulation of Zn, Cu, Co, Se, and Mo in the soil. In addition, the main source of Mn metal is believed to be natural due to geological activities in the region.

Long-Term Sex-Specific Effects of Cadmium Exposure on Osteoporosis and Bone Density: A 10-Year Community-Based Cohort Study

This study explored the long-term effects of cadmium (Cd) exposure on osteoporosis incidence and bone mineral density (BMD). This retrospective cohort study included men aged ≥50 years and post-menopausal women from the 2001−2002 Korea Genome and Epidemiology Study. Participants previously diagnosed with osteoporosis were excluded. Blood Cd concentrations were measured and categorized as <0.5, 0.5−1.0, and >1.0 μg/L. BMD was measured using quantitative ultrasound. Osteoporosis was diagnosed when the T-score was ≤−2.5. Confounders that affect exposure and outcome were controlled. Osteoporosis incidence and differences in BMD (ΔBMD) were assessed until 2012. The osteoporosis incidence among 243 participants who were followed up for an average of 6.3 years was 22.2%. In all the participants, a dose−response relationship was observed between blood Cd and incident osteoporosis and ΔBMD (both p-for-trend < 0.01). After adjusting for age, sex, smoking, physical activity, body mass index, creatinine, and baseline BMD, a blood Cd concentration of >1.0 μg/L was an independent risk factor for incident osteoporosis and decrements in ΔBMD. In women, blood Cd concentrations of >0.5 μg/L increased the risk for osteoporosis. Exposure to Cd prospectively increases the risk for osteoporosis and decrements of ΔBMD, particularly in women, even in lower doses of Cd.