ArticleBMC medicine2022
Biological aging mediates the associations between urinary metals and osteoarthritis among U.S. adults.
Article in BMC medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 101 papers.
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Who cites it
101 citing papers in PubMed, 197 citations in OpenAlex.
- Integrative analysis of cadmium exposure and osteoarthritis: from population evidence to molecular mechanisms.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Association Between Exposure to Multiple Metal Elements and Cognitive Function in Older Adults: The Mediating Role of Branched-Chain Amino Acids.Biological trace element research · 2026Article
- Association between adverse childhood experiences and accelerated aging of middle-aged and older Chinese: based on the China health and retirement longitudinal study.BMC public health · 2026Observational
- Relationship between dietary diversity and periodontitis: analysis of NHANES 2003-2014.Acta odontologica Scandinavica · 2026Article
- Associations Between Hair Heavy Metal Concentrations and Frailty in Mexican Adults: a Cross-Sectional Study.Research square · 2026Article
- Association of the waist-to-weight index with low back pain: a mediation analysis involving accelerated biological ageing.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Association between sarcopenia and mortality in patients with osteoarthritis.Clinical rheumatology · 2026Article
- Deciphering the obesity paradox in phenotypic age acceleration through thyroid hormone sensitivity: results from NHANES 2007-2010.Hormones (Athens, Greece) · 2026Article
- Research on the imbalance of metal homeostasis and ferroptosis mechanisms in neurodegenerative diseases.Global medical genetics · 2026Article
- Accelerated biological aging and brain structural alterations linking air pollution to dementia risk: a prospective cohort study.The journal of nutrition, health & aging · 2026Article
- Association between frailty and chronic lung diseases in middle aged and older population.BMC public health · 2026Article
- Associations of Biological Age and Heart Age Accelerations With New-Onset Stroke in Individuals With Cardiovascular-Kidney-Metabolic Syndrome Stages 0-3: Evidence From a Chinese Longitudinal Study.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Review
- The impact of triglyceride-glucose-related obesity indices and sleep patterns on accelerated aging: evidence from NHANES 2005-2018.Hormones (Athens, Greece) · 2026Article
- Age-specific associations between per- and polyfluoroalkyl substance exposure and osteoarthritis: a cross-sectional study.Clinical rheumatology · 2026Article
- From algorithm to verification: based on network toxicology and machine learning, the immunomodulatory role of IGFBP1/MKI67/C9 in perfluorooctanoic acid-induced osteoarthritis was discovered, and a diagnostic model was constructed.Frontiers in immunology · 2026Article
- Telomere length in leukocyte as biomarker for diagnosis of primary Sjögren's syndrome: a cross-sectional study.Clinical rheumatology · 2026Article
- Long-term exposure to low concentrations of ambient benzene with incident thyroid dysfunction and the mediating role of accelerated biological aging.Frontiers in public health · 2026Article
- The impact of mixed exposure to PMFrontiers in public health · 2026Article
- Article
41 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOsteoarthritis (OA) is a worldwide public health concern, mainly afflicting older adults. Although the etiology of OA remains unclear, environmental factors are increasingly considered as non-negligible risk factors. This study aims to evaluate the associations of urinary metals with OA risk and the mediated effect of biological aging.
methodsNine urinary metal concentrations were detected among 12,584 U.S. adults based on the National Health and Nutrition Examination Survey (NHANES), including barium (Ba), cadmium (Cd), cobalt (Co), cesium (Cs), molybdenum (Mo), lead (Pb), antimony (Sb), thallium (Tl), and uranium (Tu). Multivariable logistic regression and weighted quantile sum (WQS) regression were used to explore the associations of single metal and mixed metals with OA risk, respectively. Furthermore, biological aging was measured from different perspectives, including cell senescence (telomere length) and whole-body aging (phenotypic age and biological age). Mediation analyses were conducted to investigate the mediated effects of aging on the associations of metals with OA risk.
resultsIn the single-exposure model, Cd, Co, and Cs were identified to be positively associated with OA risk, with odds ratios (OR) ranging from 1.48 to 1.64 (all P < 0.05). Mixed-exposure analyses showed consistent associations (OR 1.23, 95%CI 1.10 to 1.37) and highlighted that Cd, Co, and Cs were responsible for the outcomes. Additionally, Cd, Co, Cs, Pb, and Tl were positively associated with biological aging markers, while all biological aging markers had significant associations with OA risk. Further mediation analyses showed that the associations of single metal (mainly Cd and Cs) and mixed metals with OA risk parallelly mediated by the above biological aging markers, with the proportion of mediation ranging from 16.89 to 69.39% (all P < 0.05). Moreover, such associations were also serially mediated through telomere length-biological age path and telomere length-phenotypic age path (the proportion of mediation: 4.17-11.67%), indicating that metals accelerated cell senescence to lead to whole-body aging and finally aggravated OA progress.
conclusionsThese findings suggested that exposure to metals increased OA risk, which was possibly and partly mediated by biological aging.
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