Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China.
Institute of Chronic Disease Prevention and Cure, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China.
Osteoporos Int. 2022 Nov;33(11):2357-2368. doi: 10.1007/s00198-022-06488-7. Epub 2022 Jul 13.
We hypothesized that air pollution could cause oxidative damage and inflammation in the human body, which was linked to bone loss. Our result showed that long-term exposure to air pollution might decrease bone mineral density (BMD) T-score and increase the prevalence of osteoporosis in Hubei province.
Osteoporosis is becoming an increasingly serious public health problem with the advent of global aging. Long-term exposure to air pollution has been linked to multitudinous adverse health outcomes, but evidence is still relatively limited and inconsistent for BMD T-score and osteoporosis. This study aimed at exploring the associations between long-term exposure to air pollution and BMD T-score and osteoporosis.
The Hubei part of the China Osteoporosis Prevalence Study was extracted. Data on air pollutants were collected by the national air quality real-time release platform of China Environmental Monitoring Station. Linear mixed models and multilevel logistic regression analyses were performed to assess the associations between air pollution and BMD T-score and osteoporosis, respectively. Subgroup analyses were conducted to identify vulnerable populations.
A total of 1845 participants were included in this cross-section study. Per 10 ug/m increase in PM and SO were associated with 0.20 (95% CI: 0.04, 0.36) and 0.31 (95% CI: 0.11, 0.51) decrease in BMD T-score of the neck of femur, respectively. Per 10 ug/m increase in CO was linked with 0.03 (95% CI: 0.02, 0.05) decrease in BMD T-score of the total hip. Per 1 ug/m increase in PM was associated with 5% increase in the prevalence of osteoporosis in all participants. In general, the higher concentrations of PM with the more adverse effect on osteoporosis (P for trend = 0.01). The impact of PM on osteoporosis in males was higher than that in females [1.29, 95% CI (1.11, 1.50) vs 1.01, 95% CI (0.95, 1.07)]. Per 1 ug/m increase in PM corresponded with 4% elevation in the risks of osteoporosis in rural population. The ORs (95% CI) for the association of osteoporosis and NO in ever/current smoking and drinking population were 1.07 (1.01, 1.13) and 1.05 (1.00, 1.09), respectively. SO had a statistically significant positive effect on people with comorbidity [OR = 1.10, (95% CI: 1.00 to 1.21)], while none in people without comorbidity [OR = 0.96, (95% CI: 0.88 to 1.05)].
Our study provided evidence that long-term exposure to PM was linked with the decreased BMD T-score and increased risk of osteoporosis among all participants. The adverse impacts of PM, PM, and NO were larger in males than in females. People having comorbidity, living in rural areas, and current/ever smoking or drinking were more vulnerable to air pollution. Public health departments should consider air pollution to formulate better preventive measures for osteoporosis.
我们假设空气污染可能导致人体氧化损伤和炎症，从而导致骨质流失。我们的研究结果表明，长期暴露于空气污染可能会降低湖北省的骨矿物质密度（BMD）T 评分，并增加骨质疏松症的患病率。
本研究从中国骨质疏松症患病率研究的湖北省部分提取数据。空气污染数据由中国环境监测站国家空气质量实时发布平台收集。采用线性混合模型和多水平逻辑回归分析分别评估空气污染与 BMD T 评分和骨质疏松症之间的关联。进行亚组分析以确定易感人群。
共纳入 1845 名参与者进行横断面研究。与 PM 和 SO 每增加 10ug/m3 相比，颈骨 BMD T 评分分别降低 0.20（95%CI：0.04，0.36）和 0.31（95%CI：0.11，0.51）。与 CO 每增加 10ug/m3 相比，全髋关节 BMD T 评分降低 0.03（95%CI：0.02，0.05）。与 PM 每增加 1ug/m3 相比，所有参与者骨质疏松症的患病率增加 5%。总体而言，PM 浓度越高，对骨质疏松症的影响越不利（P 趋势=0.01）。PM 对男性骨质疏松症的影响高于女性[1.29，95%CI（1.11，1.50）比 1.01，95%CI（0.95，1.07）]。PM 每增加 1ug/m3，农村人口骨质疏松症的风险增加 4%。在有或无合并症的人群中，NO 与骨质疏松症的关联的 OR（95%CI）分别为 1.07（1.01，1.13）和 1.05（1.00，1.09）。SO 对有合并症的人群有统计学意义上的正效应[OR=1.10，（95%CI：1.00 至 1.21）]，而对无合并症的人群没有影响[OR=0.96，（95%CI：0.88 至 1.05）]。
本研究提供的证据表明，长期暴露于 PM 与所有参与者的 BMD T 评分降低和骨质疏松症风险增加有关。PM、PM 和 NO 的不良影响在男性中大于女性。有合并症的人、居住在农村地区的人、目前或曾经吸烟或饮酒的人更容易受到空气污染的影响。公共卫生部门应考虑空气污染，制定更好的骨质疏松症预防措施。
