The Impact of Heavy Metals on Osteoporosis in Postmenopausal Women

Shiyu Peng Zhang Gaoxiang ^* Decheng Wang ^* Zhiliang He ^*

• Department of Spinal Trauma，Beijing Tongzhou District Hospital of Integrated Traditional Chinese and Western Medicine, Beijing, China

Objective: Heavy metals are present in many environmental pollutants which can lead to several diseases, including OP. However, limited information was known about the correlation between OP and heavy metals, especially in postmenopausal women. The current research was aimed to explore the association heavy metals and BMD with OP risk among postmenopausal women in the US. This cross-sectional study enrolled participants in NHANES 2013-2014 and 2017-2020. ICP-MS was applied to detect five metals, namely, Pb, Cd, Hg, Se and Mn, in blood. BMD was measured through DXA and then converted to T-scores.At the same time, the impacts of exposure to single and mixed metals on OP were assessed using multivariable logistic regression, WQS, and BKMR models. The relationship was examined based on age and BMI.Results: Totally 905 postmenopausal women were enrolled for final analysis. Among them, 161 (17.80%) participants had OP. Logistic regression indicated that, Cd (OR [95% CI]: 1.815 [1.076, 3.061] and 2.180 [1.309, 3.631], separately) and Se (OR [95% CI]: 0.570 [0.356, 0.914], 0.454 [0.276, 0.747] and 0.689[0.433, 1.097], separately) were related to OP in the adjusted model 1. Similar results to model 1 were obtained by the rest models. Multivariate linear regression model analysis suggested that subjects who had the greatest quartile of Cd level exhibited lower BMD within the entire femur (β = -0.112, P = 0.007) compared to those in Q1. The WQS analysis suggested that Cd was correlated positively with increased OP risk, whereas Se inversely associated. In BKMR analysis, exposure to mixed metals was significantly positively related to OP.In subgroup analysis, Cd's impact on OP risk was most pronounced in the 50-60 year age and 25-30 kg/m2 BMI subgroups, and Se offered protection in older age and higher BMI groups. The results showed that the increased mixed metal concentration may lead to an increased OP risk among postmenopausal women. Blood Cd level was associated with an increased OP risk, and blood Se level served as the predicting factor for OP. More investigations are warranted to demonstrate our findings and elucidate the underlying biological mechanism.