Association Of Polycyclic Aromatic Hydrocarbons With Osteoporosis

BackgroundOsteoporosis is a metabolic systemic bone disease characterized by normal calcification of the bone tissue,normal ratio of calcium salt to matrix,and reduced amount of bone mass per unit volume.With the global aging process accelerating,the number of osteoporosis patients was increasing.Osteoporosis has become a major public health problem.The prevalence of osteoporosis in the elderly was 13%-30%;one third of the world's women and one-fifth of men suffered from osteoporotic fractures.Osteoporosis not only caused the loss of healthy life years,but also increased the social burden and caused serious economic losses.Therefore,a comprehensive understanding of the pathogenesis of osteoporosis is conducive to us to take more reasonable and effective preventive measures.However,existed researches about the environmental pollutants and osteoporosis were rare.Environmental pollutants polycyclic aromatic hydrocarbons(PAHs)have been shown to cause body damage,such as disorders in thyroid secretion,carcinogenesis of partially polycyclic aromatic hydrocarbons and disturbs in the immune system.However its relationship with osteoporosis remained unclear.In fact,the mechanism of polycyclic aromatic hydrocarbons causing body damage has been studied.It shown that polycyclic aromatic hydrocarbons could enhance the body's oxidative stress,making the increase in the number of reactive oxygen species,moreover studies showed that osteoporosis occurred with the increased formation of reactive oxygen species in bone cells.Although there was a common passageway between osteoporosis and PAHs,it was unclear whether the two were related.Therefore,we assumed that polycyclic aromatic hydrocarbons could increase the prevalence of osteoporosis and studied it using data from National Health and Nutrition Examination Survey.Objectives1.To explore the relationship between osteoporosis and PAHs with controlling of other confounding factors.2.Explore the relative importance of risk factors for osteoporosis.MethodsThis study used data from National Health and Nutrition Examination Survey(NHANES).The National health and nutrition examination survey project began in the 1960s and became a continuous project in 1999.This project aimed to assess the health and nutritional status of adults and children in the United States,the prevalence of the disease,risk factors for disease,nutritional status,and their relationship to health promotion and disease prevention.The project used a multi-stage sampling method to extract samples.The investigation of osteoporosis started in 2005,and missed in 2011 and 2012,the data after 2014 was not updated.Therefore,we used four rounds of survey data for 2005-2006,2007-2008,2009-2010,and 2013-2014.The population we studied was men over the age of 50 and women over age of 50 and menopausal.Osteoporosis was defined in accordance with the National Osteoporosis Health Association's Expanded Diagnostic Criteria.Polycyclic aromatic hydrocarbons(monohydroxy PAHs)in urine were quantified by HPLC-ESI-MS/MS in order to represent the content of polycyclic aromatic hydrocarbons.The concentration of monohydroxy PAHs in urine was geometrically distributed,so we converted them logarithmically.Demographic characteristics,such as lifestyle,disease history and other indicators were obtained through the questionnaire.Since the project used a multistage sampling method to extract samples,we used the weighted estimation method in the description of basic features and logistic regression analysis.To know about the relative importance of the risk factors,we performed dominance analysis.We stated that statistically significance was P<0.05 with two-sided test in overall study.Stata 15.1 was used for data compilation and analysis.Main resultsThe prevalence of osteoporosis in women was 8%higher than in men.With aging the prevalence of osteoporosis increased,and the prevalence of osteoporosis among those over 70 years old was four times than that of those aged 50-59.The prevalence of osteoporosis in the black was lower than in Asians and Caucasians,accounted for about one-third of Caucasians.With body fat index increased,the prevalence of osteoporosis decreased.Ever osteoporosis in people with a prevalence of about 40%was higher than the general population.In addition,the prevalence of current smokers was higher than never smokers.Univariate analysis showed that 1-hydroxynaphthalene was positive associated with osteoporosis(OR=1.08,95%CI:1.00-1.16).After adjusting for gender,age,race,education level,family economic status,weight,food calcium intake,drinking,previous fracture history,parental fracture history,and glucocorticoid drug use,2-hydroxynaphthalene was positive associated with osteoporosis(OR=1.22,95%CI:1.01-1.48).Further control of smoking,the association between 2-hydroxynaphthalene and osteoporosis was still existed(OR=1.29,95%CI:1.06-1.57).Dominance analysis showed that previous health status was the primary factor for osteoporosis,and the second factor was sociological factor,2-hydroxynaphthalene was the third important factor.ConclusionsAfter controlling confused factors,2-hydroxy naphthalene was positive associated with osteoporosis.Previous health status was the primary factor among the risk factors,sociological factor was the second important factor,and 2-hydroxynaphthalene was the third important factor for osteoporosis.