Lead and calcium content in the human hip joint

Pollutants: a candidate as a new risk factor for osteoarthritis-results from a systematic literature review

Background

Considering non-classical environmental risk factors for osteoarthritis (OA), a systematic literature review (SLR) was performed to summarise existing knowledge on associations between OA and pollutants.

Methods

PubMed was used to identify studies reporting data on OA and pollutants in humans (examples of MeSH terms: “Pesticides” or “Polychlorinated Biphenyls” or ‘Lead’). Reports included epidemiological clinical studies, pollutant assessments in ex vivo OA joint, and in vitro effects of pollutants on chondrocytes.

Results

Among the 193 potentially relevant articles, 14 were selected and combined with 9 articles obtained by manual search. Among these 23 articles there were: (1) 11 epidemiological studies on the relationship between OA and pollutants exposure, (2) 8 on pollutant concentrations in ex vivo OA joint, (3) 4 on the in vitro effects of pollutants on human chondrocytes. Epidemiological studies investigating mainly chlorinated and fluorinated pollutants suggested a possible link with OA. In cross-sectional studies, radiographic knee OA prevalence increased with higher serum lead levels. There was also a relationship between serum lead levels and serum/urine joint biomarkers. A high concentration of heavy metals in the cartilage tidemark was found in ex vivo joints. In vitro, the viability of chondrocytes was reduced in presence of some pollutants. However, the level of knowledge currently remains low, justifying the need for new methodologically sound studies.

Conclusions

This SLR supports the hypothesis of a possible involvement of pollutants in OA disease risk. Large-scale epidemiological and biological studies and ideally big-data analysis are needed to confirm that pollutants could be risk factors for OA.

Sex- and Age-Related Dynamic Changes of the Macroelements Content in the Femoral Bone with Hip Osteoarthritis

Simple Summary

The study assessed the content of macroelements Ca, Mg, P, and Na in the proximal femoral bone tissue in patients with hip osteoarthritis, and it correlated with age, sex, and BMI. The high reduction of macroelements in the femoral bone of patients with hip osteoarthritis is more pronounced in the cortical bone and occurs in women under 60 years of age. In men, it begins in the seventh and increases in the eighth decade of life.

Abstract

Background: The content of macroelements in bones varies with age and depends on sex. The aim of the study was to evaluate the content of macroelements and its correlation with age and sex in the femoral bone obtained during total hip arthroplasty. Methods: In the 86 patients, the content of macroelements (Ca, P, Mg, and Na) in the femoral head and neck (cancellous and cortical bone) was assessed by means of the inductively coupled plasma optical emission spectrometry analytical technique (ICP-OES). Results: There was a decrease in the content of macroelements in the cortical bone with age in the women in the 51–60 years (statistically significant: −0.59 for Ca, −0.65 for P) and over 70 years age groups (correlation not statistically significant: −0.29 for Ca, −0.38 for P). A significant decrease in the content of macroelements in the cortical bone was found in men over 70 years of age. Conclusions: Patterns of increased loss of macronutrients (Ca, P, and Mg) in the femoral neck (cortical bone) were demonstrated in the following patients with osteoarthritis: women aged 51–60 years and patients of both sexes over 70 years of age.

Factors Affecting the Aluminum, Arsenic, Cadmium and Lead Concentrations in the Knee Joint Structures

Background: Toxic elements, such as aluminum (Al), arsenic (As), cadmium (Cd), and lead (Pb), are persistent environmental pollutants that can cause adverse effects on the health of exposed individuals. Bone is one of the primary target organs of accumulation and potential damage from toxic elements. Objectives: This study was performed to determine the Al, As, Cd, and Pb concentrations in the femoral cancellous bone, femoral cartilage, anterior cruciate ligament, meniscus, tibial cartilage, tibial cancellous bone and infrapatellar fat pad. Furthermore, the aim of this study was to explore the relationships between toxic element concentrations and related factors such as gender, age, place of residence, hypertension and diabetes, and to determine the correlations among these toxic elements in knee joint structures. Methods: The samples used this study were collected from 51 patients following total knee arthroplasty. The Al, As, Cd, and Pb concentrations were determined using inductively coupled plasma optic emission spectrometry. Results: Significant differences were found in the Al, As, Cd, and Pb concentrations among the knee joint structures. Cd concentration in the tibial cancellous bone in women was significantly higher than in men. Pb concentration in the infrapatellar fat pad of urban patients was significantly higher as compared to rural patients. Al concentrations in the femoral cancellous bone, femoral cartilage, anterior cruciate ligament, meniscus and tibial cartilage were significantly higher in patients living in urban areas than in rural areas. As concentration in the tibial cancellous bone of diabetic patients was significantly higher compared to non-diabetic patients. In addition, significant Spearman's positive correlations were found between Al and Pb in the knee joint structures. Conclusion: The obtained results of the investigated toxic elements may serve as a basis for establishing the reference values of Al, As, Cd, and Pb in the knee joint structures. The results reported in the study provides novel data regarding the relationships between the toxic element concentrations and gender, age, place of residence, hypertension and diabetes in the studied structures of knee joint. Furthermore, new interactions among these toxic elements were noted.

The Effects of Calcium, Magnesium, Phosphorus, Fluoride, and Lead on Bone Tissue

Bones are metabolically active organs. Their reconstruction is crucial for the proper functioning of the skeletal system during bone growth and remodeling, fracture healing, and maintaining calcium-phosphorus homeostasis. The bone metabolism and tissue properties are influenced by trace elements that may act either indirectly through the regulation of macromineral metabolism, or directly by affecting osteoblast and osteoclast proliferation or activity, or through becoming part of the bone mineral matrix. This study analyzes the skeletal impact of macroelements (calcium, magnesium, phosphorus), microelements (fluorine), and heavy metals (lead), and discusses the concentration of each of these elements in the various bone tissues.

Concentration of Selected Elements in the Infrapatellar Fat Pad of Patients with a History of Total Knee Arthroplasty

In the period of long development, the human body adapted to specific concentrations of trace elements. Any changes in the trace element content manifesting in a deficiency or excess of metals in the human body may impair the functioning of the skeletal and articular system and of the organs, and may also predispose the body to the development of diseases, i.e., osteoporosis. Our study aimed to analyze the concentrations of calcium (Ca), magnesium (Mg), fluorides (F-), and lead (Pb) in the infrapatellar fat pad (Hoffa’s fat pad) of subjects who had undergone a total knee replacement (TKR) surgery. We also endeavored to establish how concentration levels of those elements are affected by selected biological and environmental factors. The studied group comprised 48 residents of Western Pomerania Province: 34 women (n = 34) aged 56–87 and 12 men (n = 12) aged 59–85. Concentration levels of Ca, Mg, and Pb were established using inductively coupled plasma-atomic emission spectrometry (ICP-AES). A Thermo Orion ion-selective electrode was applied for measuring F- concentration. Subjects aged 75–87 showed higher Mg concentration values than those aged 56–74. Big city residents and smokers were found to have higher infrapatellar fat pad Mg concentration than their non-smoking counterparts and small town dwellers. Of all the elements whose concentrations we analyzed in our studies, only magnesium was found to correlate with smoking, place of residence, and age. Our findings regarding the quantities of selected elements in the infrapatellar fat pad may be used for the interpretation and analysis of biological, morphological, and mechanical changes in the human body.

Calcium, magnesium, zinc and lead concentrations in the structures forming knee joint in patients with osteoarthritis‬

The aim of the study was to investigate the relationships between the concentrations of calcium (Ca), magnesium (Mg), zinc (Zn), and lead (Pb) in cartilage, anterior cruciate ligament, and meniscus samples obtained following knee joint surgery in patients with osteoarthritis in northwestern Poland.‬ Furthermore, we examined the relationships between the concentrations of these metals in the studied parts of the knee joint and the influences of gender, age, BMI and hypertension. We found significantly higher concentrations of Ca, Mg, and Zn in the cartilage of men than in women and a significantly higher Pb concentration in the meniscus of the men. We also found a higher concentration of Pb in the cartilage of patients over 65 years of age.‬ There were no differences in the concentrations of the studied metals between patients with and without hypertension.‬ There was no relationship between Ca, Mg, Zn, and Pb levels in analyzed materials and BMI. Furthermore, we noted some new interactions between metals in the studied structures of the knee joint. The results reported in the study shows the influence of age, gender and BMI on the Ca, Mg, Zn and Pb in the studied structures of the knee joint.

Factors that Affect the Content of Cadmium, Nickel, Copper and Zinc in Tissues of the Knee Joint

Osteoarthritis causes the degradation of the articular cartilage and periarticular bones. Trace elements influence the growth, development and condition of the bone tissue. Changes to the mineral composition of the bone tissue can cause degenerative changes and fractures. The aim of the research was to determine the content of cadmium (Cd), nickel (Ni), copper (Cu) and zinc (Zn) in the tibia, the femur and the meniscus in men and women who underwent a knee replacement surgery. Samples were collected from 50 patients, including 36 women and 14 men. The determination of trace elements content were performed by ICP-AES method, using Varian 710-ES. Average concentration in the tissues of the knee joint teeth amounted for cadmium 0.015, nickel 0.60, copper 0.89 and zinc 80.81 mg/kg wet weight. There were statistically significant differences in the content of cadmium, copper and zinc in different parts of the knee joint. There were no statistically significant differences in the content of cadmium, nickel, copper and zinc in women and men in the examined parts of the knee joint. Among the elements tested, copper and nickel showed a high content in the connective tissue (the meniscus) compared to the bone tissue (the tibia and the femur).

Preliminary Study to Test the Feasibility of Sex Identification of Human (Homo sapiens) Bones Based on Differences in Elemental Profiles Determined by Handheld X-ray Fluorescence

Sex assignment of human remains is a crucial step in forensic anthropological studies. The aim of this study was to examine elemental differences between male and female bones using X-ray fluorescence (XRF) and determine if elemental profiling could be used for sex discrimination. Cranium, humerus, and os coxae of 60 skeletons (30 male, 30 female) from the Chiang Mai University Skeletal Collection were scanned by XRF and differences in elemental profiles between male and female bones determined using discriminant analysis. In the cranium, three elements (S, Ca, Pb) were significantly higher in males and five elements (Si, Mn, Fe, Zn, Ag) plus light elements (atomic number lower than 12) were higher in females. In humerus and os coxae, nine elements were significantly higher in male and one element was higher in female samples. The accuracy rate for sex estimation was 60, 63, and 61 % for cranium, humerus, and os coxae, respectively, and 67 % when data for all three bones were combined. We conclude that there are sex differences in bone elemental profiles; however, the accuracy of XRF analyses for discriminating between male and female samples was low compared to standard morphometric and molecular methods. XRF could be used on small samples that cannot be sexed by traditional morphological methods, but more work is needed to increase the power of this technique for gender assignment.

Influence of Environmental Factors and Relationships between Vanadium, Chromium, and Calcium in Human Bone

The aim of this study was to investigate the impact of environmental factors on the concentrations of vanadium (V), chromium (Cr), and calcium (Ca) and to examine the synergistic or antagonistic relationships between these metals, in cartilage (C), cortical bone (CB), and spongy bone (SB) samples obtained following hip joint surgery on patients with osteoarthritis in NW Poland. We found significantly higher concentrations of V and Cr in spongy bone in patients who consumed game meat and also those with prosthetic implants. Chromium levels were significantly lower in patients with kidney diseases. The greatest positive correlations were found between spongy bone V and (i) the amount of consumed beer and (ii) seafood diet. Correlation analysis also showed a significant correlation between Cr levels and seafood diet. To a certain extent these results indicate that the concentrations of V, Cr, and Ca in the human hip joint tissues are connected with occupational exposure, kidney diseases, diet containing game meat, sea food, beer, and the presence of implants. Furthermore, we noted new types of interactions in specific parts of the femoral head. Vanadium may contribute to the lower bone Ca levels, especially in the external parts (cartilage and cortical bone).

Influence of calcium on choline measurements by 1H MR spectroscopy of thigh muscles

OBJECTIVE

To study the effects of calcium on the choline peak measurements with 1H MR spectroscopy.

MATERIAL AND METHODS

The thigh muscles of two cadaveric specimens were prospectively evaluated on a 3 T MR unit before and after the injection of calcium carbonate (up to 0.4322 g). The choline peaks of 147 spectra from 10 different anatomic locations were quantitatively evaluated. The influence of the calcium concentration and its disposition with respect to the main magnetic field were considered. B0 phase maps were used to evaluate field inhomogeneities.

RESULTS

The presence of calcium led to a 43 % underestimation of the choline peak and the choline concentration (p = 0.0002 and 0.0036). The mean choline concentrations before and after CaCO3 injection were 3.53 ± 1.72 mmol/l and 1.58 ± 0.63 mmol/l. The influence of calcium carbonate on the choline peak estimations was proportional to the calcium concentration. There was a significant position-dependent difference in the estimation of the choline peak amplitude (p < 0.0154). Calcium injection led to a measurable increase in field inhomogeneities.

CONCLUSION

There was a significant underestimation of the choline peak amplitude and concentration in the presence of calcium, which might cause misinterpretations of MR spectra.

KEY POINTS

The presence of calcium led to significant underestimation of choline measurements. The influence of calcium is dependent on its concentration and distribution. Quantitative MR spectroscopy of calcified tumours should be interpreted with caution.

The content of manganese and iron in hip joint tissue

Manganese and iron are elements that constitute components of bone tissue. The aim of this study was to determine presence of manganese and iron in hip joint tissue and interdependencies between these elements. The objects of the research were hip joint elements from people residing in cities on the territory of the Upper Silesian Industrial District. The number of people in the study group was 91 samples, including 66 samples from women and 25 from a man. The examined tissues were obtained intraoperatively during hip replacement procedures. The content of manganese and iron was determined using the atomic absorption spectrophotometry (AAS) method. The lowest content of manganese and iron was found in the cortical bone, and the largest, in the case of manganese, in the articular cartilage, whereas in the case of iron in a fragment of the cancellous bone from the intertrochanteric area. The content of iron in selected elements of the hip joint decreased with age. Higher content of manganese in hip joint tissue of women compared to men was confirmed. What is more, higher content of iron in hip joint tissue of men was confirmed as well.

Concentrations of trace elements in bones of the hip joint from patients after hip replacement surgery

The aim of this research was to determine the concentrations of two essential elements (copper (Cu) and zinc (Zn)) and three toxic elements (lead (Pb), cadmium (Cd) and mercury (Hg)) in the hip joint bones of patients from the Chair and Clinic of Orthopaedics and Traumatology at the Pomeranian Medical University in Szczecin. We examined 111 samples of hip joint bones obtained from patients from north-western Poland who had undergone arthroplasty of the femoral head. In cartilage with the adjacent compact bone, and in spongy bone from the examined patients, the concentrations (medians) determined were placed in the following descending sequence Zn>Pb>Cu>Cd>Hg. The concentrations ranged from 86 mg Zn/kg to 0.0020 mg Hg/kg dw. It was found that the concentration of lead in the cartilage with adjacent compact bone was higher in men than in women. In conclusion, it seems that in addition to routine monitoring of the abiotic environment, it is essential to monitor concentrations of heavy metals having a long-term impact in humans.