Huang Jun-Wei, Fang Wen-Hui, Chen Wei-Liang
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.
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.
Biol Trace Elem Res. 2023 Jan;201(1):82-89. doi: 10.1007/s12011-022-03143-4. Epub 2022 Feb 9.
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.
骨质疏松症已被公认为是导致老年人残疾的重要原因，会带来沉重的社会经济负担。目前的测量方法，如双能X线吸收法（DEXA）和骨矿物质密度（BMD）存在局限性。相比之下，小梁骨评分（TBS）是一种新兴的骨质量评估工具。我们研究的目的是调查TBS与微量元素（镉和铅）之间的关系。我们分析了2005 - 2006年和2007 - 2008年国家健康与营养检查调查（NHANES）数据集的所有受试者，本研究共纳入8244名参与者；49.4%的入选受试者为男性。我们使用血镉（Cd）和血铅（Pb）浓度来定义环境暴露情况。主要变量是TBS和BMD。其他重要的人口统计学特征作为协变量纳入，随后使用线性回归模型进行调整，以确定基于血微量元素浓度的TBS与四个四分位数之间的关联，同时考虑性别差异。完全调整后的回归模型显示，TBS与血镉（B - Cd）之间存在负相关关系，这在男性和女性中均具有统计学意义（p均<0.05）。男性的β系数为 - 0.009（95%置信区间（CI）：（-0.015至 - 0.004）），女性为 - 0.019（95%CI：（-0.024至 - 0.013））。我们还发现，TBS与B - Cd之间在两性中均存在剂量依赖关系（趋势p均<0.05）。我们的研究得出结论，TBS可以衡量男性和女性与镉相关的骨质量恶化情况。
