Association of aldehyde exposure with bone mineral density in the national health and nutrition examination survey (NHANES 2013-2014)

Role of active and environmental tobacco smoke on susceptibility to osteoporosis in women undergoing dual-X-ray absorptiometry

PURPOSE

Current smoking is a risk factor for osteoporosis (Op), but few data are available regarding the passive smoke impact on Op susceptibility. This cross-sectional study aimed to evaluate the association between the smoking habits and Op in community-dwelling women undergoing dual-energy X-ray absorptiometry (DXA).

METHODS

On 01/06/2018, general practitioners from "COMEGEN" Medical Cooperative, Naples, Italy, selected the medical records from the last 10 years of women who had a measurement of bone mineral density performed and simultaneously completed a questionnaire about their smoking behaviour and their cohabiters'. The binary logistic regression analysis was used to estimate the role of passive smoke on the risk of Op, adjusting for age and body mass index (BMI).

RESULTS

Among 10,616 subjects, 3942 were currently smokers [CS; mean age 69.4 ± 10.4 years; BMI 27.0 ± 4.9 kg/m2], 873 were passive smokers (PS; mean age 67.8 ± 11.6 years; BMI 27.0 ± 4.9 kg/m2) and 5781 were never smokers (NS; mean age 67.8 ± 11.6 years; body mass index (BMI) 27.0 ± 4.9 kg/m2). Of all, 8562 women (mean age 70.3 ± 10.2 yrs; BMI 27.0 ± 4.9 kg/m2) received the Op diagnosis. PS showed an increased Op risk compared to NS [odds ratio (OR) 1.38 (1.14-1.67)] and comparable to CS [OR 1.02 (0.84-1.24)].

CONCLUSION

The study results demonstrate an association between passive smoke and Op in community-dwelling women already presenting with susceptibility to Op according to Italian essential assistance levels, suggesting that passive and active smoke are equivalent Op risk factors in women.

Serum Concentrations of Benzaldehyde, Isopentanaldehyde and Sex Hormones: Evidence from the National Health and Nutrition Examination Survey

Exposure to environmental chemicals could disturb the balance of sex hormones. However, the studies on Benzaldehyde, Isopentanaldehyde exposure and sex hormones are still limited. Based on the data of 1064 participants in the National Health and Nutrition Examination Survey (NHANES), we used the linear regression model and restricted cubic spline (RCS) model to evaluate the associations of Benzaldehyde/Isopentanaldehyde exposure with testosterone (TT), estradiol (E2), sex hormone binding globulin (SHBG), free androgen index (FAI) and the ratio of TT to E2 (TT/E2). A ln-unit increase in Benzaldehyde was associated with lower TT (β = -0.048, P = 0.030) and E2 (β = -0.094, P = 0.046) in all participants. After further adjustment for menopausal status, Benzaldehyde was negatively associated with E2 (β = -0.174, P = 0.045) in females. The interaction between Benzaldehyde and gender was significant (P_inter = 0.031). However, Isopentanaldehyde showed a positive association with SHBG and TT/E2 in all participants (all P < 0.05). The positive associations of Isopentanaldehyde with TT, SHBG and TT/E2 were found in males but not in females. RCS plots illustrated the linear associations of Benzaldehyde with E2 (P_non-linear = 0.05) in females and Isopentanaldehyde with TT (P_non-linear = 0.07) and TT/E2 (P_non-linear = 0.350) in males. The non-linear relationships were identified between Isopentanaldehyde and SHBG in males (P_non-linear = 0.035). Our findings indicated the effects of Benzaldehyde and Isopentanaldehyde exposure on sex hormones, and the effects had the gender specificity. Cohort studies and high-quality in vitro and in vivo experiments are needed to confirm the specific effects and uncover the underlying mechanisms.

Association between mixed aldehydes and bone mineral density based on four statistical models

Aldehydes as an environmental pollutant may lead to oxidative stress, which is an important mechanism in the development of osteoporosis. This suggests a possible link between aldehyde exposure and osteoporosis. Considering the mixed nature of aldehyde exposure and the interactions between different aldehydes, we explored for the first time the associations between mixed six aldehydes (benzaldehyde, butyraldehyde, heptanal, hexanal, isovaleraldehyde, and propionaldehyde) and BMD in three populations (men, premenopausal women, and postmenopausal women) by applying four statistical models: quantile g-computation (qgcomp) model, Bayesian kernel machine regression (BKMR) model, generalized linear regression model (GLM), and generalized additive model (GAM), based on the National Health and Nutrition Examination Survey (NHANES) 2013-2014. We found that mixed aldehydes could significantly reduce BMD in men, with hexanaldehyde and propanaldehyde having the greatest negative qgcomp model and BKMR model weights, also confirmed by GLM. The associations between isopentanaldehyde and propanaldehyde and femoral BMD in men were non-linear and had threshold effects as derived from the BKMR model and GAM. The associations turned positive when the concentrations of isopentanaldehyde and propanaldehyde exceeded their respective inflection points. To conclude, our study might provide new ideas for the prevention and treatment of osteoporosis, and hexanaldehyde and propanaldehyde should be more regulated to prevent osteoporosis.

TSH levels within the normal range and risk of cardiovascular and all-cause mortality among individuals with diabetes

BACKGROUND

Evidence regarding thyroid-stimulating hormone (TSH) levels within the normal range and mortality in adults with diabetes is scarce. This study aimed to identify the association between TSH levels and cardiovascular disease (CVD) and all-cause mortality among euthyroid patients with diabetes.

METHODS

This prospective cohort study included 1830 adults with diabetes from the Third National Health and Nutrition Examination Survey III. Mortality outcomes were ascertained by linkage to National Death Index records through December 31, 2019. Participants were categorized by tertiles of TSH levels (low-normal, 0.39-1.30 mIU/L; medium-normal, 1.30-2.09 mIU/L; high-normal, 2.09-4.60 mIU/L). Multivariable Cox proportional hazards models were used to explore the association between TSH levels within the normal range and overall and CVD mortality. Furthermore, restricted cubic spline analyses were used to determine the nonlinear relationship between TSH levels and mortality.

RESULTS

During a median follow-up of 17.1 years, 1324 all-cause deaths occurred, including 525 deaths from CVD. After multivariate adjustment, a U-shaped relationship was observed between TSH levels in euthyroid status and all-cause or CVD mortality among patients with diabetes (both P < 0.05 for nonlinearity). Compared with participants with medium-normal TSH levels, those with high-normal TSH levels had a significantly higher risk of all-cause (hazard ratio, 1.31; 95% confidence interval, 1.07-1.61) and CVD (1.52; 1.08-2.12) mortality. Similarly, low-normal TSH levels also increased all-cause (1.39; 1.12-1.73) and CVD (1.69; 1.17-2.44) mortality risk. In stratum-specific analyses, we found that high-normal TSH levels were associated with higher mortality risk in younger (< 60 years) patients with diabetes but not in older (≥ 60 years) participants.

CONCLUSION

Low- and high-normal serum TSH levels were associated with increased all-cause and CVD mortality in euthyroid adults with diabetes. Further studies are needed to confirm the present observation in a wider population.