Dataset Information

Arsenic, cadmium, and selenium exposures and bone mineral density-related endpoints: The HORTEGA study.

ABSTRACT:

Background and objectives

Experimental data suggest that trace elements, such as arsenic (As), cadmium (Cd), and selenium (Se) can influence the bone remodeling process. We evaluated the cross-sectional association between As, Cd, and Se biomarkers with bone mineral density (BMD) measured at the calcaneus, in a representative sample of a general population from Spain. As secondary analyses we evaluated the associations of interest in subgroups defined by well-established BMD determinants, and also conducted prospective analysis of osteoporosis-related incident bone fractures restricted to participants older than 50 years-old.

Methods

In N = 1365 Hortega Study participants >20 years-old, urine As and Cd were measured by inductively coupled-plasma mass spectrometry (ICPMS); plasma Se was measured by atomic absorption spectrometry (AAS) with graphite furnace; and BMD at the calcaneus was measured using the Peripheral Instaneuous X-ray Imaging system (PIXI). As levels were corrected for arsenobetaine (Asb) to account for inorganic As exposure.

Results

The median of total urine As, Asb-corrected urine As, urine Cd, and plasma Se was 61.3, 6.53 and 0.39 μg/g creatinine, and 84.9 μg/L, respectively. In cross-sectional analysis, urine As and Cd were not associated with reduced BMD (T-score < -1 SD). We observed a non-linear dose-response of Se and reduced BMD, showing an inverse association below ~105 μg/L, which became increasingly positive above ~105 μg/L. The evaluated subgroups did not show differential associations. In prospective analysis, while we also observed a U-shape dose-response of Se with the incidence of osteoporosis-related bone fractures, the positive association above ~105 μg/L was markedly stronger, compared to the cross-sectional analysis.

Conclusions

Our results support that Se, but not As and Cd, was associated to BMD-related disease. The association of Se and BMD-related disease was non-linear, including a strong positive association with osteoporosis-related bone fractures risk at the higher Se exposure range. Considering the substantial burden of bone loss in elderly populations, additional large prospective studies are needed to confirm the relevance of our findings to bone loss prevention in the population depending on Se exposure levels.

SUBMITTER: Galvez-Fernandez M

PROVIDER: S-EPMC9019194 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Arsenic, cadmium, and selenium exposures and bone mineral density-related endpoints: The HORTEGA study.

Galvez-Fernandez Marta M Grau-Perez Maria M Garcia-Barrera Tamara T Ramirez-Acosta Sara S Gomez-Ariza Jose L JL Perez-Gomez Beatriz B Galan-Labaca Iñaki I Navas-Acien Ana A Redon Josep J Briongos-Figuero Laisa S LS Dueñas-Laita Antonio A Perez-Castrillon Jose Luis JL Tellez-Plaza Maria M Martin-Escudero Juan Carlos JC

Free radical biology & medicine 20201031

<h4>Background and objectives</h4>Experimental data suggest that trace elements, such as arsenic (As), cadmium (Cd), and selenium (Se) can influence the bone remodeling process. We evaluated the cross-sectional association between As, Cd, and Se biomarkers with bone mineral density (BMD) measured at the calcaneus, in a representative sample of a general population from Spain. As secondary analyses we evaluated the associations of interest in subgroups defined by well-established BMD determinants ...[more]

PMID: 33137469

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Project description:BackgroundOsteoporosis, characterized by reduced bone mineral density (BMD) increases the risk of all-cause mortality. Assessments of whether dietary selenium intake is related to bone health are scarce, with few relevant studies limited by a small sample size. The aim of the present study was to investigate the association between dietary selenium intake and BMD levels in the National Health and Nutrition Examination Survey (NHANES) database.MethodsWe extracted and aggregated data from 4 cycles of the NHANES [2005-2010, 2013-2014]. Dietary selenium intake was obtained from 24-hour dietary recall interviews. BMD measurement, including the femur, femur neck, trochanter and intertrochanter of the femur, and lumbar spine, was performed using dual-energy X-ray absorptiometry. The multivariable linear regression model for the association between dietary selenium intake and BMD and the generalized additive model (GAM) for the dose-response relationship were used.ResultsA total of 21,939 participants were included. The mean age was 40.68±22.42 years, and 51.28% were male. In the multivariable adjustment model, participants with the highest quintiles of dietary selenium intake (Q5) were associated with increased BMD levels in the total femur (β=0.014, 95% CI: 0.008-0.020, P<0.001), femur neck (β=0.010, 95% CI: 0.004-0.016, P=0.001), trochanter (β=0.011, 95% CI: 0.005-0.017, P<0.001), intertrochanter (β=0.017, 95% CI: 0.010-0.025, P<0.001), and lumbar spine (β=0.013, 95% CI: 0.005-0.020, P<0.001) compared with those in quintile 1 (Q1). The dose-response relationship showed an inverted U-shape relationship between dietary selenium intake and BMD levels (P for nonlinearity <0.05). Participants tended to have increased levels of BMD as the dietary selenium intake increased when dietary selenium was below the turning point, and then a negative relationship was observed when dietary intake was higher than the turning point.ConclusionsOur study indicated that dietary selenium intake exhibited an inverted U-shape trend in relation to BMD levels, which demonstrates the need for selenium status in the body to be considered when discussing the role of dietary selenium intake in BMD. Future studies are needed to confirm these findings and explore the underlying biological mechanism.

Project description:BackgroundCadmium (Cd) can cause renal damage and osteoporosis after high-level exposure. Recently such effects, including increased urinary excretion of calcium, have been shown also at low-level exposure, as measured by Cd in blood or urine. However, associations with kidney Cd have not been examined. The aim of this study was to explore the relation between kidney Cd and urinary calcium excretion, or bone mineral density.MethodsCd was determined in kidney cortex biopsies from 109 living kidney donors. Serum was analyzed for ionized calcium, parathyroid hormone and vitamin D. Calcium was analyzed in overnight and 24-hour urine samples. Bone mineral density was measured in a subgroup of 67 donors. Associations between single variables were assessed by Spearman and Pearson correlation coefficients. Differences between independent groups were compared using Student's t-test. For related samples, paired t-test was applied. Associations between urinary calcium and kidney Cd, ionized serum calcium, serum parathyroid hormone, inactive and active vitamin D and background variables were assessed using multiple linear regression and logistic regression.ResultsIn spite of relatively low kidney Cd levels (median 13 ?g/g, range 1.5-55 ?g/g) kidney Cd and urinary calcium were positively associated, mainly caused by an association in women. Donors with kidney Cd above the median (subgroup mean 23 ?g/g) had significantly higher excretion of urinary calcium normalized for creatinine than those below the median (subgroup mean 7.3 ?g/g). In women, also the excretion of Ca per hour was higher in those with high kidney Cd (24 hour sample mean 0.21 vs. 0.15 mmol/h; overnight sample 0.16 vs. 0.11 mmol/h). There were negative associations between kidney Cd and bone mineral density, most of which, however, disappeared in multivariate analyses.ConclusionsThis study provides support for an association between kidney Cd levels and urinary calcium excretion in women, but not in men. The results strengthen the case for preventive measures against Cd pollution.

Dataset Information

Arsenic, cadmium, and selenium exposures and bone mineral density-related endpoints: The HORTEGA study.

Background and objectives

Methods

Results

Conclusions

Publications

Arsenic, cadmium, and selenium exposures and bone mineral density-related endpoints: The HORTEGA study.

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