Association between outdoor particulate air pollution and the risk of osteoporosis: a systematic review and meta-analysis

Liu, J J; Fu, Songbo; Jiang, Jingrong; Tang, Xulei

doi:10.1007/s00198-021-05961-z

Cited by 32 publications

(13 citation statements)

References 26 publications

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“…Similarly, a previous Korean study using the same cohort sample datasets, focusing on women aged >50 y, applying a time-independent PM exposure around the middle point of the follow-up period (2008–2009), and adjusting for age, income, CCI, BMI, smoking, drinking, exercise, and total cholesterol, did not find associations of PM 10 and osteoporotic fracture [ 18 ]. According to a recent systematic review [ 34 ], O 3 and hip fracture has only been studied in a time-series analysis conducted for Spain [ 17 ], and this study showed no associations between O 3 and hip fracture. While our study was based on retrospective cohort design and examined long-term air pollution exposure, we also found no associations between O 3 and osteoporotic fracture.…”

Section: Discussionmentioning

confidence: 86%

Associations between Long-Term Air Pollution Exposure and Risk of Osteoporosis-Related Fracture in a Nationwide Cohort Study in South Korea

Heo

Kim

et al. 2022

IJERPH

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Bone health is a major concern for aging populations globally. Osteoporosis and bone mineral density are associated with air pollution, but less is known about the impacts of air pollution on osteoporotic fracture. We aimed to assess the associations between long-term air pollution exposure and risk of osteoporotic fracture in seven large Korean cities. We used Cox proportional hazard models to estimate hazard rations (HRs) of time-varying moving window of past exposures of particulate matter (PM10), sulfur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), and ozone (O3) for osteoporotic fracture in Korean adults (age ≥50 y) in the National Health Insurance Service-National Sample Cohort data, followed 2002 to 2015. HRs were calculated for an interquartile range (IQR) increase. Comorbidity and prescription associated with osteoporosis, age, sex, body mass index, health behaviors, and income were adjusted in the models. Effect modification by age, sex, exercise, and income was examined. We assessed 56,467 participants over 535,481 person-years of follow up. Linear and positive exposure-response associations were found for SO2, while PM10 and NO2 showed nonlinear associations. SO2 was associated with osteoporosis-related fracture with marginal significance (HR for an IQR [2 ppb] increase = 1.04, 95% CI: 1.00, 1.09). The SO2 HR estimates were robust in analyses applying various moving windows of exposure (from one to three years of past exposure) and two-pollutant models. The central HR estimate of O3 implied positive associations but was not significant (HR for 0.007 ppm increase = 1.01, 95% CI: 0.97, 1.06). PM10, CO, and NO2 did not show associations. Vulnerable groups by sex, age, exercise, and income varied across air pollutants and there was no evidence of effect modifications. Long-term exposure to SO2, but not PM10, CO, NO2 and O3, was associated with increased osteoporotic fracture risks in Korean adults.

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Section: Discussionmentioning

confidence: 86%

Associations between Long-Term Air Pollution Exposure and Risk of Osteoporosis-Related Fracture in a Nationwide Cohort Study in South Korea

Heo

Kim

et al. 2022

IJERPH

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“…In our study, we included more regions of China, and found that the prevalence of osteoporosis of the inland regions including the southeast, the southwest, the northwest and the northeast were relatively higher than that of the eastern coastal regions. Multiple region-related factors, such as genetic predisposition, latitude and longitude ( 3 ), diet ( 16 , 17 ), sunlight ( 18 ), physical activities ( 19 ), lifestyles ( 20 ), socioeconomic status ( 21 ), and even environment pollution ( 22 , 23 ), could contribute to the differences in the prevalence of different regions of China.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of osteoporosis in China, a community based cohort study of osteoporosis

Wang

Shu

Tang

et al. 2023

Front. Public Health

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BackgroundOsteoporosis has already been a growing health concern worldwide. The influence of living area, lifestyle, socioeconomic, and medical conditions on the occurrence of osteoporosis in the middle-aged and elderly people in China has not been fully addressed.MethodsThe study was a multicenter cross-sectional study on the middle-aged and elderly permanent residents, which gathered information of 22,081 residents from June 2015 to August 2021 in seven representative regions of China. The bone mineral density of lumbar vertebrae and hip were determined using the dual-energy X-ray absorptiometry densitometer instruments. Serum levels of bone metabolism markers were also measured. Information about education, smoking, and chronic diseases were also collected through face-to-face interviews. Age-standardized prevalence and 95% confidence intervals (CIs) of osteopenia and osteoporosis by various criteria were estimated by subgroups and overall based on the data of China 2010 census. The relationships between the osteoporosis or osteopenia and sociodemographic variables or other factors were examined using univariate linear models and multivariable multinomial logit analyses.ResultsAfter screening, 19,848 participants (90%) were enrolled for the final analysis. The age-standardized prevalence of osteoporosis was estimated to be 33.49%(95%CI, 32.80–34.18%) in the middle-aged and elderly Chinese permanent residents, for men and women was 20.73% (95% CI, 19.58–21.87%) and 38.05% (95% CI, 37.22–38.89%), respectively. The serum concentrations of bone metabolic markers, and calcium and phosphorus metabolism were influenced by age, body mass index (BMI), gender, education level, regions, and bone mass status. Women, aged 60 or above, BMI lower than 18.5 kg/m2, low education level including middle school, primary school and no formal education as well as current regular smoking, a history of fracture were all significantly associated with a higher risk of osteoporosis and osteopenia in the middle-aged and elderly people.ConclusionsThis study revealed dramatic regional differences in osteoporosis prevalence in China, and female, aged 60 or older, low BMI, low education level, current regular smoking, and a history of fracture were associated with a high risk of osteoporosis. More prevention and treatment resources should be invested into particular population exposed to these risk factors.

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“…Researchers have also explored the potential effects of air pollutants on bone health. For instance, a meta-analysis showed a particulate matter with diameters <2.5 μm (PM 2.5 ) and nitrogen dioxide (NO 2 ) are associated with an elevated risk of osteoporosis ( 11 ). However, the effect of other air pollutants on bone fracture remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Risk of ozone exposure-induced fracture

Lü

Gong

et al. 2023

Front. Public Health

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IntroductionOzone (O3) is known to induce oxidative stress that influences various cells and tissues, which may further lead to diminished bone mineral density. Nevertheless, few studies have investigated the association between O3 exposure and fractures. Considering the similar growing trends of O3 concentrations and fracture morbidity in recent years, in the present study, we aimed to examine whether O3 exposure is associated with the fracture morbidity.MethodsUsing a retrospective cohort study design, we analyzed the records of 8,075 patients with fracture admitted in the warm season to Beijing Jishuitan Hospital from 2014 to 2019 and matched them to the corresponding exposure time and concentration of O3.ResultsThe results showed that increased odds of fracture were associated with increased O3 concentrations, presumably because O3 induces oxidative stress (OS) that leads to bone mineral density (BMD) loss.DiscussionOur findings suggest that O3 exposure is a risk factor for fractures, providing new evidence of the adverse health effect induced by air pollution. We can conclude that more intensive air pollution control is needed for the prevention of fracture occurrence.

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Association between outdoor particulate air pollution and the risk of osteoporosis: a systematic review and meta-analysis

Cited by 32 publications

References 26 publications

Associations between Long-Term Air Pollution Exposure and Risk of Osteoporosis-Related Fracture in a Nationwide Cohort Study in South Korea

Associations between Long-Term Air Pollution Exposure and Risk of Osteoporosis-Related Fracture in a Nationwide Cohort Study in South Korea

The prevalence of osteoporosis in China, a community based cohort study of osteoporosis

Risk of ozone exposure-induced fracture

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