Analysis of the association between mixed exposure to multiple metals and comorbidity of osteopenia or osteoporosis: baseline data from the Chinese Multi-Ethnic Cohort study (CMEC).

Both osteoporosis and metal exposure are well-recognized public health concerns globally, particularly in the aging population. However, studies investigating the relationship between metal exposure and bone health conditions such as osteopenia and osteoporosis have either produced inconsistent results or are scarce, especially among the ethnic minorities in China. Herein, we correlated single-metal and metal mixture exposure with osteopenia and osteoporosis using a log-binomial regression model and quantile g-computation. In total, 9,206 ethnic Chinese individuals (Dong and Miao) aged 30-79 years were investigated in this study utilizing the baseline data from the Chinese multi-ethnic cohort study. In the single-metal exposure model, urinary concentrations of arsenic (As), cadmium (Cd), chromium (Cr), iron(Fe), mercury(Hg), and manganese (Mn) were positively associated with of osteopenia, whereas those of cobalt(Co) and zinc(Zn) concentrations were negatively associated. Additionally, urinary As, Cd, Cr, and Mn concentrations were positively associated with osteoporosis, whereas that of vanadium(V) was negatively associated. Furthermore, Quantile g-computation results indicated that metal mixture exposure was positively associated with both osteopenia and osteoporosis. Altogether, these findings suggest that simultaneous exposure to multiple metals can affect bone health, providing a theoretical basis for further studies on underlying complex mechanisms.