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. 2024 May 22;19(5):e0303418.
doi: 10.1371/journal.pone.0303418. eCollection 2024.

Associations between co‑exposure to heavy metals and vertebral compression fracture, as well as femoral neck bone mineral density: A cross-sectional study from NHANES data

Xurong Yang  1 , Li Li  2 , Lixiong Nie  3
Affiliations

Associations between co‑exposure to heavy metals and vertebral compression fracture, as well as femoral neck bone mineral density: A cross-sectional study from NHANES data

Xurong Yang et al. PLoS One. .

Abstract

Objective: Accumulating evidence showed that exposure to heavy metals was harmful to human health. Little is known regarding the mixing effects of multiple metal exposures on vertebral compression fracture (VCF) and femoral neck bone mineral density (BMD). This study aimed to explore the individual and joint effects of four heavy metals [manganese (Mn), lead (Pb), cadmium (Cd) and mercury (Hg)] on VCF risk and femoral neck BMD.

Methods: This cross-sectional study included 1,007 eligible individuals with vertebral fractures from National Health and Nutrition Examination Survey 2013-2014. The outcome was the risk of VCF and femoral neck BMD. Weighted multivariate logistic regression was used to explore the individual effect of four heavy metals on the VCF risk, separately. Weighted multivariate linear regression was used to explore the individual effect of four heavy metals on the femoral neck BMD, separately. Adopted bayesian kernel machine regression (BKMR) model and quantile-based g computation (qgcomp) to examine the joint effects of four heavy metals on the VCF risk and femoral neck BMD.

Results: Among the population, 57 individuals developed VCF. After adjusting covariates, we found no statistical differences regarding the individual effects of four heavy metals on the risk of VCF. BKMR model and qgcomp indicated that there were no statistical differences regarding the joint effects between four heavy metals on the VCF risk. In addition, we found that Cd was associated with femoral neck BMD, and an increase in the mixture of heavy metal exposures was associated with a decreased risk of femoral neck BMD.

Conclusion: No significant correlation was observed between co-exposure to Mn, Pb, Cd and Hg and VCF risk. But co-exposure to Mn, Pb, Cd and Hg may be associated with femoral neck BMD.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The process of participants selection.
Fig 2
Fig 2. The overall association between heavy metal mixtures and VCF risk.
See this image and copyright information in PMC

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