Background

Limited studies have examined the association between air pollutants and osteoporosis incidence; however, the results are conflicting. We aimed to quantify the effects of selected air pollutants on osteoporosis risk and explore the modifying effect of genetic predisposition.

Methods

A total of 422,955 subjects who did not have osteoporosis at baseline in the UK Biobank were included from 2006 to 2010. We conducted a Cox proportional hazards model with adjustment for covariates to examine the association between air pollutant scores and individual air pollutants and incident osteoporosis. Furthermore, a polygenic risk score (PRS) of osteoporosis was built and examined to determine whether genetic susceptibility modified the effect of air pollutants on osteoporosis. The relationship between air pollutants and osteoporosis was examined by using a restricted cubic spline (RCS) method.

Results

After confounder adjustment, the results showed a remarkable increase in the risk of osteoporosis with each 10 unit increase in exposure to air pollution (hazard ratio: 1.06, 95 % confidence interval: 1.03–1.08), PM_2.5 (1.94, 1.52–2.48), NO₂ (1.06, 1.02–1.10), and NO_X (1.03, 1.01–1.04). However, no significant association was observed between PM₁₀ or PM_2.5-10 exposure and osteoporosis. Subjects with high air pollutant exposure levels and a high PRS had a noteworthy increase in osteoporosis risk compared to those with low air pollutant exposure levels and a low PRS. Air pollutants and genetic variants exerted additive effects on the risk of osteoporosis. Positive correlations were observed between osteoporosis and PM_2.5 (P < 0.001), NO₂ (P = 0.001), and NOx (P = 0.002) exposure.

Conclusions

Exposure to PM_2.5, NO₂ and NOx was associated with an increase in osteoporosis risk, and this effect was more pronounced in populations with high genetic risk. The association between PM_2.5, NO₂ and NOx exposure and osteoporosis is modified by genetic variations.

中文翻译：

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空气污染物与骨质疏松症风险的关联：遗传易感性的改变作用

背景

有限的研究探讨了空气污染物与骨质疏松症发病率之间的关系；然而，结果是相互矛盾的。我们的目的是量化选定的空气污染物对骨质疏松症风险的影响，并探索遗传易感性的改变作用。

方法

2006 年至 2010 年，英国生物银行总共纳入了 422,955 名基线时未患有骨质疏松症的受试者。我们进行了 Cox 比例风险模型，并对协变量进行了调整，以检查空气污染物评分与个体空气污染物和骨质疏松症事件之间的关联。此外，还建立并检查了骨质疏松症的多基因风险评分（PRS），以确定遗传易感性是否改变了空气污染物对骨质疏松症的影响。使用限制三次样条（RCS）方法检查空气污染物与骨质疏松症之间的关系。

结果

混杂因素调整后，结果显示，空气污染暴露量每增加 10 个单位，骨质疏松症的风险就会显着增加（风险比：1.06，95% 置信区间：1.03–1.08），PM 2.5（_{1.94，1.52–2.48}） 、NO ₂ (1.06、1.02–1.10) 和 NO _X (1.03、1.01–1.04)。然而，PM ₁₀或 PM _2.5-10暴露与骨质疏松症之间没有观察到显着关联。与空气污染物暴露水平低和 PRS 低的受试者相比，空气污染物暴露水平高和 PRS 高的受试者骨质疏松风险显着增加。空气污染物和基因变异对骨质疏松症的风险产生附加影响。_{骨质疏松症与 PM 2.5} (P < 0.001)、NO ₂ (P = 0.001) 和 NOx (P = 0.002) 暴露之间存在正相关性。

结论

暴露于PM _2.5、NO ₂和NOx 与骨质疏松症风险增加相关，并且这种影响在高遗传风险人群中更为明显。_{PM 2.5}、NO ₂和NOx 暴露与骨质疏松症之间的关联因遗传变异而改变。