Background: Lead exposure continues to be an important issue for human health. Previous studies indicated that lead may directly affect osteoblast and osteoclast function, and indirectly influence bone turnover due to kidney dysfunction. Some animal research also demonstrated that lead exposure was associated with decreasing bone mineral density. However, the evidence from the human study is lacking. Aims: Our objective is to investigate the association between lead exposure and adult bone health. Methods: Participants' data (n=439) were drawn from the Nutrition and Health Survey in Taiwan (NAHSIT) for 2005-2008. It was a national survey with high representativeness in Taiwan. Bone health was divided into normal (T-score ＞ -1), osteopenia (T-score between -1 and -2.5) or osteoporosis (T-score ＜ -2.5). We used inductively coupled plasma mass spectrometry (ICP-MS) to analyze urinary cadmium and urinary lead levels. Every participant completed the questionnaire including their education, household income, smoking status, alcohol consumption, diet supplement consumption, and outdoor activity. Results: In multivariable logistic regression, increasing age (OR = 1.07; 95% CI = 1.04-1.10; p ＜ 0.001), former smoker (OR = 2.99; 95% CI = 1.20-7.44; p = 0.01) and high urinary lead level (OR = 1.98; 95% CI = 1.00-3.90; p = 0.04) were found to be associated with osteopenia or osteoporosis. After further stratification by gender, increasing age still associated with osteopenia or osteoporosis in both men and women. High urinary lead level was observed to increase risk of osteopenia or osteoporosis in women (OR = 2.66; 95% CI = 1.01-7.06; p = 0.04), but not in men. Conclusions: The results suggest that women with high urinary lead level have higher risk of osteopenia or osteoporosis.
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机译：背景：铅曝光仍然是人类健康的重要问题。以前的研究表明，铅可能直接影响成骨细胞和骨质体功能，并且由于肾功能障碍而间接影响骨周转。一些动物研究还证明了铅暴露与骨密度的降低有关。然而，缺乏人类研究的证据。目的：我们的目标是调查铅暴露和成人骨骼健康之间的关联。方法：参与者的数据（N = 439）是从台湾（Nahsit）的营养和健康调查2005-2008。这是台湾高度代表性的国家调查。骨健康分为正常（T分数> -1），骨质减少或骨质疏松症（T分数<-2.5）（T分数和-2.5之间-1）。我们使用电感耦合等离子体质谱（ICP-MS）来分析尿镉和尿铅水平。每个参与者都完成了调查问卷，包括其教育，家庭收入，吸烟状态，酒精消费，饮食补充消费和户外活动。结果：在多变量的逻辑回归，增加年龄（或= 1.07; 95％CI = 1.04-1.10; P <0.001），前吸烟者（或= 2.99; 95％CI = 1.20-7.44; P = 0.01）和高尿铅水平（或= 1.98; 95％CI = 1.00-3.90; p = 0.04）与骨质增生或骨质疏松症有关。经过性别进一步分层，增加年龄仍然与男性和女性的骨质增长或骨质疏松症相关。观察到高尿铅水平，以增加骨瘦如柴或女性骨质疏松症的风险（或= 2.66; 95％CI = 1.01-7.06; p = 0.04），但不是男性。结论：结果表明，具有高尿液水平的妇女具有较高风险的骨质增长或骨质疏松症。
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