Association Between Combined Polymetallic Exposure and Osteoporosis

Combined polymetallic exposure may be an influential factor in osteoporosis. This study aimed to explore the association between polymetallic combined exposure and osteoporosis. A total of 2115 participants were included. Plasma concentrations of 22 metals were determined by inductively coupled plasma mass spectrometry. Osteoporosis was defined as a T ≤  - 2.5. The least absolute shrinkage and selection operator (LASSO) regression, binary logistics regression, and Bayesian kernel machine regression (BKMR) model were used to explore the association between plasma metals and osteoporosis. LASSO regression showed that 10 metals were associated with osteoporosis in the total population (magnesium, calcium, manganese, nickel, cobalt, arsenic, selenium, rubidium, cadmium, aluminum) and women (magnesium, calcium, molybdenum, nickel, cobalt, arsenic, selenium, rubidium, cadmium, aluminum), and four metals associated with men (magnesium, cobalt, aluminum, iron). Logistics regression showed that in total population, magnesium (OR_Q3 = 0.653, 95% CI = 0.446-0.954) was negatively correlated with osteoporosis, while aluminum (OR_Q2 = 1.569, 95% CI = 1.095-2.248, OR_Q4 = 1.616, 95% CI = 1.109-2.354) and cadmium (OR_Q4 = 1.989, 95% CI = 1.379-2.870) were positively correlated; in women, magnesium (OR_Q3 = 0.579, 95% CI = 0.379-0.883) was negatively correlated with osteoporosis, while aluminum (OR_Q2 = 1.563, 95% CI = 1.051-2.326, OR_Q4 = 1.543, 95% CI = 1.024-2.326) and cadmium (OR_Q3 = 1.482, 95% CI = 1.003-2.191, OR_Q4 = 1.740, 95% CI = 1.167-2.596) were positively correlated. BKMR model showed that combined polymetallic exposure had an overall positive effect on osteoporosis, magnesium was negatively associated with osteoporosis, and cadmium, selenium, and aluminum were positively associated with osteoporosis. Metal mixtures in plasma were associated with osteoporosis risk. Magnesium may reduce the risk of osteoporosis, while cadmium, selenium, and aluminum may increase the risk of osteoporosis. Future studies needed to explore correlations and mechanisms.