Association of air particulate pollution with bone loss over time and bone fracture risk: analysis of data from two independent studies.
Association of air particulate pollution with bone loss over time and bone fracture risk: analysis of data from two independent studies.
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DOI：
10.1016/s2542-5196(17)30136-5
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发表时间：
2017-11
期刊：
影响因子：
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通讯作者：
Baccarelli AA
中科院分区：
文献类型：
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作者：
Prada D;Zhong J;Colicino E;Zanobetti A;Schwartz J;Dagincourt N;Fang SC;Kloog I;Zmuda JM;Holick M;Herrera LA;Hou L;Dominici F;Bartali B;Baccarelli AA
空气颗粒物（PM）是一种普遍存在的环境暴露，与氧化、炎症和年龄相关的慢性疾病有关。PM是否与骨密度（BMD）损失和骨折风险相关尚不确定。我们进行了两项补充性研究：(i) 2003-2010年间美国东北部/中大西洋地区920万医疗保险参保者的长期PM <2.5 μm （PM2.5）水平和骨质疏松相关骨折住院率；（ii）长期黑碳[BC]和PM2.5水平，血清钙稳态生物标志物（甲状旁腺激素，钙和25-羟基维生素D），以及在8年随访期间692名中年（46.7±12.3岁），低收入BACH/Bone队列参与者的年化骨密度降低。在Medicare分析中，PM2.5水平较高的地区骨质疏松相关部位的骨折入院风险更大（风险比[RR] 1.041, 95%可信区间[CI]， 1.030, 1.051）。这种风险在低收入社区尤其高（RR 1.076; 95% CI, 1.052, 1.100）。在纵向BACH/Bone研究中，基线BC和PM2.5水平与较低的血清PTH相关（1年平均BC基线四分位数增长估计值= - 1.16,95%CI - 1.93, - 0.38； 1年平均PM2.5基线四分位数增长估计值= - 7.39;95%CI - 14.17, - 0.61）。随着时间的推移，BC水平与多个解剖部位较高的骨密度损失相关，包括股骨颈（- 0.08%/年每四分位数增加；95% CI - 0.14, - 0.02%/年）和桡骨超远端（- 0.06%/年每四分位数增加；95% CI - 0.12, - 0.01%/年）。我们的研究结果表明，空气质量差是骨折和骨质疏松症的一个可改变的危险因素，特别是在低收入社区。
Air particulate matter (PM) is a ubiquitous environmental exposure associated with oxidation, inflammation, and age-related chronic disease. Whether PM is associated with loss of bone mineral density (BMD) and risk of bone fractures is undetermined. We conducted two complementary studies of: (i) long-term PM <2.5 μm (PM2.5) levels and osteoporosis-related fracture hospital admissions among 9.2 million Medicare enrollees of the Northeast/Mid-Atlantic United States between 2003–2010; (ii) long-term black carbon [BC] and PM2.5 levels, serum calcium homeostasis biomarkers (parathyroid hormone, calcium, and 25-hydroxyvitamin D), and annualized BMD reduction over a 8-year follow-up of 692 middle-aged (46.7±12.3 yrs), low-income BACH/Bone cohort participants. In the Medicare analysis, risk of bone fracture admissions at osteoporosis-related sites was greater in areas with higher PM2.5 levels (Risk ratio [RR] 1.041, 95% Confidence Interval [CI], 1.030, 1.051). This risk was particularly high among low-income communities (RR 1.076; 95% CI, 1.052, 1.100). In the longitudinal BACH/Bone study, baseline BC and PM2.5 levels were associated with lower serum PTH (Estimate for baseline one interquartile increase in 1-year average BC= −1.16, 95% CI −1.93, −0.38; Estimate for baseline one interquartile increase in 1-year average PM2.5= −7.39; 95%CI −14.17, −0.61). BC level was associated with higher BMD loss over time at multiple anatomical sites, including femoral neck (−0.08%/year per one interquartile increase; 95% CI −0.14, −0.02%/year) and ultradistal radius (−0.06%/year per one interquartile increase; 95% CI −0.12, −0.01%/year). Our results suggest that poor air quality is a modifiable risk factor for bone fractures and osteoporosis, especially in low-income communities.