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. 2025 May 22:13:1561920.
doi: 10.3389/fpubh.2025.1561920. eCollection 2025.

Associations between blood ethylene oxide levels and bone mineral density

Wenwen Chen  1   2 , Sujuan Lu  2 , Min Lin  1 , Kun Chen  3 , Feng Huang  1   4
Affiliations

Associations between blood ethylene oxide levels and bone mineral density

Wenwen Chen et al. Front Public Health. .

Abstract

Background: Ethylene oxide (EO) is a toxic compound extensively used in industrial applications. This study quantified serum EO levels by measuring hemoglobin-bound ethylene oxide (HbEO). However, the link between bone mineral density (BMD) and HbEO levels remains unexplored.

Methods: A total of 2,570 participants were evaluated using data from National Health and Nutrition Examination Survey (NHANES) (2015-2018). Generalized linear regression models (LRM) and restricted cubic spline (RCS) analyses were used to investigate the association between blood EO levels and BMD. Adjusted models were also applied for comprehensive analysis.

Results: Blood EO levels and BMD were inversely related (p = 0.007). This RCS analysis also showed an L-shaped dose-response correlation between EO levels and BMD (p for nonlinearity <0.001).

Conclusion: This study highlights a substantial correlation between EO exposure and BMD. Further randomized controlled trials are required to establish a causal relationship.

Keywords: NHANES; bone mineral density; ethylene oxide; inflammation; oxidative stress.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart portraying the sample selection.
Figure 2
Figure 2
Multivariable-adjusted restricted cubic spline curve for the association between blood ethylene oxide levels and bone mineral density. The solid red line represents the fitted curve; the light red area represents the confidence interval.
See this image and copyright information in PMC

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