Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.
Institute of Radiation Medicine, Fudan University, 2094 Xietu road, Shanghai, 200032, China.
Environ Geochem Health. 2022 Jun;44(6):1673-1682. doi: 10.1007/s10653-021-01129-0. Epub 2021 Oct 26.
Low hemoglobin (Hb) level or anemia is associated with osteoporosis and bone fracture. Cadmium (Cd) and lead (Pb) exposure are also risk factors of osteoporosis and anemia. However, the role of anemia in Cd/Pb related bone loss remains unclear. The aim of present study was to investigate the association between Hb level and bone loss in a population with environmental lead and cadmium exposure. One hundred and ninety-four women and 108 men with different levels of Cd/Pb exposure were included in our study. The Cd/Pb exposure was determined using graphite-furnace atomic absorption spectrometry. Forearm bone mineral density (BMD) was determined by peripheral dual-energy X-ray absortiometry. Hb concentration was determined using an automatic blood cellcounter. A logistic model was established to predict the risk of osteoporosis. The BMDs of women that had the highest quartile BCd and BPb were markedly lower than that with the lowest quartile (p < 0.05). The BMD and the prevalence of osteoporosis in men with anemia were lower and higher than that with normal Hb (p < 0.05), respectively. In men, age, BPb and anemia were independent risk factors for osteoporosis. The odds ratio (OR) of men with anemia was 11.28 (95%confidence interval (CI):1.94-65.54) and 19.56 (95%CI: 2.98-128.78) compared to those with normal Hb after adjusting for potential cofounders. No such association was found in women. The area under the curve was 0.88 (95%CI: 0.82-0.96) in predicting osteoporosis using the logistic model in men. Linear discriminant analysis also showed that 90.7% of osteoporosis was correctly classified. Our data show that anemia is associated with incident of osteoporosis in men but not in women that environmentally exposed to Pb and Cd.
血红蛋白（Hb）水平低或贫血与骨质疏松症和骨折有关。镉（Cd）和铅（Pb）暴露也是骨质疏松症和贫血的危险因素。然而，贫血在 Cd/Pb 相关骨丢失中的作用尚不清楚。本研究旨在探讨具有环境铅和镉暴露人群中 Hb 水平与骨丢失之间的关系。我们的研究纳入了 194 名女性和 108 名男性，他们的 Cd/Pb 暴露水平不同。使用石墨炉原子吸收光谱法测定 Cd/Pb 暴露水平。通过外周双能 X 射线吸收法测定前臂骨矿物质密度（BMD）。使用自动血细胞计数器测定 Hb 浓度。建立逻辑模型来预测骨质疏松症的风险。最高四分位 BCd 和 BPb 的女性 BMD 明显低于最低四分位（p<0.05）。贫血男性的 BMD 和骨质疏松症患病率低于正常 Hb 的男性（p<0.05）。在男性中，年龄、BPb 和贫血是骨质疏松症的独立危险因素。与正常 Hb 的男性相比，贫血男性的 OR 为 11.28（95%CI：1.94-65.54）和 19.56（95%CI：2.98-128.78），在调整潜在混杂因素后。在女性中未发现这种关联。使用逻辑模型预测男性骨质疏松症的曲线下面积为 0.88（95%CI：0.82-0.96）。线性判别分析也表明，90.7%的骨质疏松症得到了正确分类。我们的数据表明，贫血与 Pb 和 Cd 环境暴露的男性骨质疏松症的发生有关，但与女性无关。
