The Association Between Cobalt and Osteoporosis: A Cross-Sectional Study Utilizing NHANES Data

Area of Science:

• Environmental Health
• Bone Metabolism
• Toxicology

Background:

• Osteoporosis poses a significant public health challenge.
• Understanding environmental exposures, like cobalt, is crucial for preventing osteoporosis.
• Gaps exist in knowledge regarding low-to-moderate environmental cobalt exposure and its health effects.

Purpose of the Study:

• To investigate the association between blood cobalt levels and osteoporosis prevalence in the U.S. population.
• To explore dose-response relationships and identify vulnerable subgroups.
• To address critical gaps in understanding the effects of environmental cobalt exposure.

Main Methods:

• Analysis of 2901 adults from the National Health and Nutrition Examination Survey (NHANES) 2017-2020.
• Categorization of blood cobalt concentrations into quartiles.
• Application of multivariable logistic regression, restricted cubic splines (RCS), and the Boruta algorithm for association and dose-response analyses, adjusting for covariates.

Main Results:

• The highest blood cobalt quartile was associated with a 32% increased osteoporosis prevalence.
• A nonlinear dose-response relationship was observed, with an inflection point at 0.12 μg/L.
• Significant effect modifications were noted in females, Non-Hispanic Black individuals, and those with 9-11 years of education.

Conclusions:

• Environmental cobalt levels below current safety thresholds may be associated with higher osteoporosis prevalence.
• Females and Non-Hispanic Black populations appear particularly vulnerable to cobalt's effects on bone health.
• The findings support revising biomonitoring standards and implementing targeted screening for vulnerable groups.