Abstract：Objective To investigate the association between metal exposure and abnormal bone mineral density among middle-aged and elderly population, so as to provide a reference for environmental health risk assessment and bone health protection. Methods From March 2024 to June 2025, a multi-stage stratified random sampling method was used to select middle-aged and elderly population aged ≥50 years from communities (natural villages) around a metal smelting factory in a city of Liaoning Province as the study subjects. Data on gender, age and other information were collected through a self-designed questionnaire. Bone mineral density was measured using dual-energy X-ray absorptiometry, and the T-score was calculated. A T-score <-1.0 was defined as abnormal bone mineral density. Urinary concentrations of 13 metals were measured using inductively coupled plasma mass spectrometer. Propensity score matching was used to control confounding bias. A multivariable logistic regression model was used to analyze the association between single metal exposure and abnormal bone mineral density. A quantile g-computation model was used to analyze the association between metal mixture exposure and abnormal bone mineral density. Weighted quantile sum regression (WQS) was used to identify key contributing metals. Results A total of 1 072 middle-aged and elderly population were surveyed, including 456 males (42.54%) and 616 females (57.46%). There were 586 participants aged ≥65 years, accounting for 54.66%. Abnormal bone mineral density was detected in 586 participants, with a detection rate of 54.66%. After propensity score matching, the standardized differences of covariates in each group were all <0.1, indicating good balance between groups. With the Q1 group as the reference, exposure to lead (Q3 group, OR=1.782, 95%CI: 1.281-2.473; Q4 group, OR=2.341, 95%CI: 1.672-3.276), cadmium (Q3 group, OR=1.563, 95%CI: 1.132-2.151; Q4 group, OR=1.977, 95%CI: 1.416-2.759) and arsenic (Q3 group, OR=1.451, 95%CI: 1.049-2.001; Q4 group, OR=1.818, 95%CI: 1.311-2.529) was positively associated with abnormal bone mineral density among middle-aged and elderly population, while exposure to zinc (Q3 group, OR=0.679, 95%CI: 0.492-0.941; Q4 group, OR=0.522, 95%CI: 0.371-0.733) was negatively associated with abnormal bone mineral density among middle-aged and elderly population. Metal mixture exposure was positively associated with abnormal bone mineral density (OR=1.423, 95%CI: 1.178-1.706). The WQS analysis showed that lead, cadmium, arsenic and zinc were the key contributing metals, with weight coefficients of 0.352, 0.221, 0.148 and -0.513, respectively. Conclusions Exposure to lead, cadmium, arsenic and metal mixture exposure were significantly associated with an increased risk of abnormal bone mineral density among middle-aged and elderly population, while zinc exposure was significantly associated with a reduced risk of abnormal bone mineral density. Lead, cadmium and arsenic were identified as key risk metals, while zinc was the key protective metal.
乔宝军, 陈中兴, 李林, 张宇, 张琳. 金属暴露与中老年人骨密度异常的关联研究[J]. 预防医学, 2026, 38(10): 984-991.
QIAO Baojun, CHEN Zhongxing, LI Lin, ZHANG Yu, ZHANG Lin. Association between metal exposure and abnormal bone mineral density among middle-aged and elderly population. Preventive Medicine, 2026, 38(10): 984-991.
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