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Long-term exposure to air pollution might decrease bone mineral density T-score and increase the prevalence of osteoporosis in Hubei province: evidence from China Osteoporosis Prevalence Study

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Abstract

Summary

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.

Introduction

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.

Methods

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.

Results

A total of 1845 participants were included in this cross-section study. Per 10 ug/m3 increase in PM2.5 and SO2 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/m3 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/m3 increase in PM2.5 was associated with 5% increase in the prevalence of osteoporosis in all participants. In general, the higher concentrations of PM2.5 with the more adverse effect on osteoporosis (P for trend = 0.01). The impact of PM2.5 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/m3 increase in PM10 corresponded with 4% elevation in the risks of osteoporosis in rural population. The ORs (95% CI) for the association of osteoporosis and NO2 in ever/current smoking and drinking population were 1.07 (1.01, 1.13) and 1.05 (1.00, 1.09), respectively. SO2 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)].

Conclusion

Our study provided evidence that long-term exposure to PM2.5 was linked with the decreased BMD T-score and increased risk of osteoporosis among all participants. The adverse impacts of PM2.5, PM10, and NO2 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.

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Funding

This study was funded by grants from the Fundamental Research Funds for the Central Universities (204202021kf0044).

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Authors and Affiliations

  1. Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China

    Faxue Zhang, Xupeng Zhang, Shijie Zhu, Xiaowei Zhang, Gaichan Zhao, Dejia Li & Wei Zhu

  2. Institute of Chronic Disease Prevention and Cure, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China

    Fang Zhou & Hao Liu

Authors
  1. Faxue Zhang
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  2. Fang Zhou
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  9. Wei Zhu
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Contributions

Wei Zhu and Dejia Li conceived and designed the study; Fang Zhou and Hao Liu collected and cleaned the data; Faxue Zhang and Fang Zhou performed the data analysis and drafted the manuscript. Shijie Zhu, Xupeng Zhang, Xiaowei Zhang, and Gaichan Zhao helped revise the manuscript. All authors read and approved the final manuscript.

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Correspondence to Dejia Li or Wei Zhu.

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This study was approved by the Ethics Committee of Wuhan University.

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Faxue Zhang and Fang Zhou are co-first authors who contributed equally to this paper.

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Zhang, F., Zhou, F., Liu, H. et al. Long-term exposure to air pollution might decrease bone mineral density T-score and increase the prevalence of osteoporosis in Hubei province: evidence from China Osteoporosis Prevalence Study. Osteoporos Int 33, 2357–2368 (2022). https://doi.org/10.1007/s00198-022-06488-7

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