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The association between hemoglobin level and osteoporosis in a Chinese population with environmental lead and cadmium

Miaomiao Wang1, Xinru Wang1, Wenjing Cui1

  • 1Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.

Environmental Geochemistry and Health
|October 26, 2021
PubMed

Insights

Anemia is linked to osteoporosis in men exposed to lead and cadmium, but not in women. This study highlights anemia as a significant risk factor for bone loss in environmentally exposed men.

Area of Science:

  • Environmental health
  • Bone metabolism
  • Hematology

Background:

  • Low hemoglobin (Hb) levels, or anemia, are associated with osteoporosis and fractures.
  • Environmental exposure to cadmium (Cd) and lead (Pb) are known risk factors for both anemia and osteoporosis.
  • The specific role of anemia in cadmium and lead-induced bone loss requires further investigation.

Purpose of the Study:

  • To investigate the association between hemoglobin levels and bone loss in a population exposed to environmental lead and cadmium.
  • To determine if anemia is a risk factor for osteoporosis in individuals with environmental heavy metal exposure.

Main Methods:

  • Included 194 women and 108 men with varying Cd/Pb exposure levels.
  • Measured Cd/Pb exposure using graphite-furnace atomic absorption spectrometry.
  • Assessed forearm bone mineral density (BMD) via peripheral dual-energy X-ray absorptiometry and Hb concentration using an automatic blood cell counter.
  • Utilized logistic models and linear discriminant analysis to assess osteoporosis risk and classification.

Main Results:

  • Women in the highest quartile of Cd and Pb exposure showed significantly lower BMD compared to those in the lowest quartile.
  • In men, anemia was associated with lower BMD and a higher prevalence of osteoporosis.
  • Age, Pb exposure, and anemia were identified as independent risk factors for osteoporosis in men.
  • The odds ratio for osteoporosis in anemic men was significantly elevated (OR=11.28-19.56) compared to men with normal Hb, after adjusting for confounders.
  • No significant association between anemia and osteoporosis was found in women.

Conclusions:

  • Anemia is significantly associated with an increased risk of osteoporosis in men environmentally exposed to lead and cadmium.
  • This association was not observed in women with similar exposure levels.
  • Findings suggest sex-specific differences in the impact of anemia on heavy metal-related bone loss.

Keywords:
AnemiaBoneCadmiumHemoglobinLeadOsteoporosis

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