Plasma Metal Concentration is Sex Dependent and Associated with Fragility Fractures: Results of METOSTEO Cohort

We aimed to determine link between plasma metals concentration and the occurrence of fractures. We conducted a single-center prospective study at Rennes University Hospital. Two groups were compared: one with severe osteoporotic fractures (GMF) and a second with patients with pathological bone mineral density without fractures (GWF). Demographic data (sex, age, body mass index (BMI)), osteoporosis risk factors, along with a biological evaluation. Plasma concentrations of metals were assessed by ICP-MS. Bone mineral density was measured using the same device. A total of 221 patients were included (125 in the GMF and 96 in the GWF). GMF patients were older (77 ± 11 vs. 66 ± 13 years, p < 0.05) with no significant differences between the two groups in terms of sex, blood calcium, blood phosphorus, 25OH vitamin D, and PTH levels. In the overall population, ferritin levels were significantly higher in the GMF (272 ng/ml ± 276 vs. 200 ng/ml ± 227, p < 0.05), with this difference being mainly driven by the female population (GMF: 239 ng/ml ± 232 vs. GWF: 165 ng/ml ± 181, p < 0.05). Concerning metal concentrations, women in the GMF had significantly reduced concentrations of manganese and selenium (p < 0.05), while strontium levels were increased. In men, plasma concentrations of aluminum and cobalt were higher in the GMF (p < 0.05). Serum metal concentrations in patients with severe osteoporotic fractures varied according to sex. The increase in ferritin in women, and cobalt and aluminum in men, seems to be associated with the osteoporotic fractures' occurrence.