Associations Between Exposure to Metal Mixtures and Insufficient Bone Strength: A Cross-Sectional Study Among Children Aged 2–6 Years

• Published in: Exposure and health 2024-06, Vol.16 (3), p.791-803
• Main Authors: Liu, Yanli, Wang, Yan, Fu, Ye, Liu, Yang, Li, Mingzhu, He, Minghui, Zhang, Yao, Li, Chen, Ding, Hongcheng, Li, Xiaowen, Ji, Hongxian, Wang, Jing
• Format: Article
• Language: English
• Subjects: Age; Aquatic Pollution; Bayesian analysis; Body mass index; Bone mass; Bone strength; Bones; Children; Cobalt; Cross-sectional studies; Earth and Environmental Science; Eating behavior; Environment; Environmental Health; Epidemiology; Exposure; Families & family life; Family income; Fractures; Generalized linear models; Heavy metals; Inductively coupled plasma mass spectrometry; Lead; Mathematical models; Metal concentrations; Mixtures; Molybdenum; Older people; Original Paper; Osteoporosis; Pollution; Questionnaires; Regression analysis; Ultrasonic imaging; Urine; Waste Water Technology; Water and Health; Water Management; Water Pollution Control; Water Quality/Water Pollution
• ISSN: 2451-9766; 2451-9685
• DOI: 10.1007/s12403-023-00591-8

Studies have shown that exposure to heavy metals increases the risk of osteoporosis in the elderly population and leads to fractures. However, epidemiologic studies focus on combined effects of multiple metals on bone strength among preschoolers are scarce. Therefore, this study was conducted to examine associations of multiple metals exposure with the risk of insufficient bone strength (IBS) among 1399 children aged 2–6 years in China. Urine concentrations of 23 metals were measured using an inductively coupled plasma mass spectrometer, while bone strength was assessed using a quantitative ultrasound instrument. The weighted quantile sum (WQS) and Bayesian kernel machine regression (BKMR) models were conducted to investigate the associations between exposure to metal mixtures and IBS. In the single metal exposure model, urine cobalt and zinc were identified to be negatively associated with IBS, whereas urine lead was positively associated with IBS. Furthermore, WQS regression and BKMR analyses consistently showed that exposure to metal mixtures was inversely related to IBS, and cobalt was the main contributor to the combined effects. Such associations were more evident in children aged 2–4 years. Our findings suggested that exposure to metal mixtures was associated with bone strength among children, and cobalt was the main contributor to the overall effects. Graphical Abstract