Association between multiple urinary trace metal elements and lumbar bone mineral density in adults

Urinary trace metal elements are key biomarkers for assessing exposure to toxic metals, and are significant contributors to osteoporosis (OP). Epidemiological research examining the connection between adult bone mineral density (BMD) and trace metal elements exposure is still very scarce, nevertheless. The study aims to clarify the association between trace metal elements exposure and BMD. This cross-sectional study included 3,441 adults (aged 20 to 59) from 2011 to 2018 National Health and Nutrition Examination Survey (NHANES). Weighted multivariable logistic regression analysis, subgroup analysis, smoothing curve fitting and threshold effect analysis were conducted to explore the association between four urinary trace metal elements (barium, cesium, antimony, and tin) and BMD. We found that urinary cesium, antimony, and tin were positively associated with lumbar BMD, while urinary barium demonstrated an inverted U-shaped association in US adults. The results of this study are helpful for the development of strategies for bone mineral density management.