ArticleZhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences2025
Sex differences in association of mixed exposure to blood cadmium, lead, mercury, selenium, manganese with osteoporosis.
Article in Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesOsteoporosis is a systemic metabolic disease characterized by decreased bone mass, deterioration of bone microstructure, and increased fracture risk. Its occurrence is closely related to sex, age, and lifestyle factors. Environmental exposure to heavy metals and metalloids may also influence its development, although existing findings remain inconsistent. The sex differences in the association between mixed metal exposure and osteoporosis are still unclear. This study aims to investigate whether sex differences exist in the associations between cadmium (Cd), lead (Pb), mercury (Hg), selenium (Se), manganese (Mn), and their mixtures and osteoporosis among men aged ≥50 years and postmenopausal women, and to analyze the potential moderating effect of dairy product consumption on these associations.
methodsData from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 and 2017-2018 cycles were used. In men and women separately, generalized linear regression models (univariate regression analysis and multivariate logistic regression) were applied to examine the relationships between single-metal exposure and osteoporosis at the femoral neck and vertebrae. A weighted quantile sum (WQS) model was used to construct a weighted index of mixed metal exposure to quantify the joint effects of multiple metals. Bayesian kernel machine regression (BKMR) was used to systematically evaluate the associations between blood Cd, Pb, Hg, Se, Mn, and their mixtures and osteoporosis at different skeletal sites, capturing potential nonlinear relationships and interactions among metals. Participants were further stratified into high dairy consumption (≥7 times/week) and low dairy consumption (<7 times/week) groups to explore the potential moderating effect of dairy consumption on the association between Cd exposure and osteoporosis.
resultsMultivariate logistic regression analysis showed that, in the fully adjusted model, Cd was positively associated with femoral neck osteoporosis in men aged ≥50 years [odds ratio (
conclusionsIn men aged ≥50 years, mixed metal exposure was positively associated with osteoporosis risk at different skeletal sites (femoral neck and vertebra), with Cd contributing most to the risk. In postmenopausal women, no association between mixed metal exposure and osteoporosis risk was observed, indicating clear sex differences. Selenium and dairy consumption may be potential protective factors for osteoporosis in women, whereas such protective effects were not observed in men.
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