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Association between multiple urinary trace metal elements and lumbar bone mineral density in adults
Renhao Zhang1,2, Tianyu Fu1,2, Fengyue Guo1
1The first Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China.
Nagoya Journal of Medical Science
|May 14, 2026
Summary
Urinary trace metals like cesium, antimony, and tin show positive links to bone mineral density (BMD). However, barium exposure has an inverted U-shaped association with BMD in US adults.
Area of Science:
- Environmental health
- Toxicology
- Bone metabolism
Background:
- Urinary trace metals are biomarkers for toxic metal exposure and linked to osteoporosis.
- Limited epidemiological data exists on trace metal exposure and adult bone mineral density (BMD).
Purpose of the Study:
- To investigate the association between urinary trace metal elements and BMD in US adults.
- To identify specific trace metals impacting bone health.
Main Methods:
- Cross-sectional study of 3,441 adults (2018 NHANES).
- Analysis of four urinary trace metals: barium, cesium, antimony, and tin.
- Weighted multivariable logistic regression, subgroup, smoothing curve, and threshold effect analyses were performed.
Main Results:
- Urinary cesium, antimony, and tin were positively associated with lumbar BMD.
- Urinary barium showed an inverted U-shaped association with BMD.
- Significant associations were observed in US adults aged 20-59.
Conclusions:
- Specific urinary trace metals (cesium, antimony, tin) are linked to higher lumbar BMD.
- Barium exposure exhibits a complex, non-linear relationship with BMD.
- Findings aid in developing bone mineral density management strategies.
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