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Detrimental Association Between Blood Cadmium Concentration and Trabecular Bone Score

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Abstract

Osteoporosis has been recognized as a significant cause of disability in the elderly leading to heavy socioeconomic burden. Current measurements such as dual-energy X-ray absorptiometry (DEXA) and bone mineral density (BMD) have limitations. In contrast, trabecular bone score (TBS) is an emerging tool for bone quality assessment. The objective of our study was to investigate the relationship between TBS and trace elements (cadmium and lead). We analyzed all subjects from the 2005–2006 and 2007–2008 National Health and Nutrition Examination Survey (NHANES) dataset and included a total of 8,244 participants in our study; 49.4% of the enrolled subjects were male. We used blood cadmium (Cd) and lead (Pb) concentrations to define environmental exposure. The main variables were TBS and BMD. Other significant demographic features were included as covariates and later adjusted using linear regression models to determine the association between TBS and four quartiles based on the blood trace element concentrations with or without sex differences. The fully adjusted regression model revealed a negative relationship between TBS and blood cadmium (B-Cd) significant for both males and females (both p < 0.05). The β-coefficient for males was −0.009 (95% confidence intervals (CI): (−0.015 to −0.004)) and −0.019 for female (95% CI: (−0.024 to −0.013)). We also found a dose-dependent relationship between TBS and B-Cd for both sexes (both trend’s p < 0.05). Our study concluded that TBS could measure Cd-related bone quality deterioration for both males and females.

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Data Availability

The datasets generated during and/or analyzed during the current study are not publicly available due to containing information that could compromise the privacy of research participants but are available from the corresponding author on reasonable request.

Abbreviations

B-Cd :

Blood cadmium

B-Pb :

Blood lead

BMD :

Bone mineral density

BMI :

Body mass index

Cd :

Cadmium

CHD :

Coronary heart disease

CHF :

Congestive heart failure

CRP :

C-reactive protein

DEXA :

Dual-energy X-ray absorptiometry

FRAX :

Fracture Risk Assessment Tool

LOD :

Lower limit of detection

lsBMD :

Lumbar spine BMD

NHANES :

National Health and Nutrition Examination Survey program

Pb :

Lead

TBS :

Trabecular bone score

WHO :

World Health Organization

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Authors and Affiliations

  1. Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China

    Jun-Wei Huang, Wen-Hui Fang & Wei-Liang Chen

  2. Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Number 325, Section 2, Chang-gong Rd, Nei-Hu District, 114, Taipei, Taiwan, Republic of China

    Wei-Liang Chen

  3. Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Republic of China

    Wei-Liang Chen

Authors
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  2. Wen-Hui Fang
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Contributions

Jun-Wei Huang and Wei-Liang Chen designed the initial study. Jun-Wei Huang also managed and retrieved the data, contributed to primary data analysis and explanation, and drafted the initial script. Jun-Wei Huang and Wei-Liang Chen decided on the methods of data collection. Jun-Wei Huang and Wei-Liang Chen were both responsible for the decisions of data analysis. Wei-Liang Chen conceptualized the study, inspected all sides of the study, critically reviewed and revised the initial script, and approved the final manuscript as submitted. All authors meet the ICMJE criteria for authorship.

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Correspondence to Wei-Liang Chen.

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All statistics of this study were obtained from National Health and Nutrition Examination Survey (NHANES) database, which had been authorized by the National Center for Health Statistics (NCHS) Institutional Review Board (IRB).

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All participants were asked to complete the informed consents before survey.

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Huang, JW., Fang, WH. & Chen, WL. Detrimental Association Between Blood Cadmium Concentration and Trabecular Bone Score. Biol Trace Elem Res 201, 82–89 (2023). https://doi.org/10.1007/s12011-022-03143-4

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