Possible implication of exposure to VOCs with the development of osteoporosis in the North American population according to NHANES.

OBJECTIVE

Osteoporosis is a prevalent bone disorder influenced by both genetic and environmental factors. Volatile organic compounds (VOCs), common environmental pollutants, have been linked to various diseases, but their role in osteoporosis remains unclear. This study examines the potential association between VOC exposure and osteoporosis using NHANES data.

METHODS

Data from six cycles of the National Health and Nutrition Examination Survey (NHANES) (2005-2018) were utilized to examine the relationship between urinary VOC levels and osteoporosis. Urinary VOC metabolites were measured using ultra-performance liquid chromatography coupled with electrospray tandem mass spectrometry (UPLC-ESI/MSMS), and their concentrations were adjusted for creatinine. Osteoporosis status was self-reported. Multivariable logistic regression models were used to assess the association between VOC exposure and osteoporosis, controlling for demographic, behavioral, and clinical covariates.

RESULTS

Analysis of 14,945 NHANES participants (2005-2018) revealed elevated osteoporosis risk associated with urinary volatile organic compounds (VOCs). Participants with osteoporosis were older (48.4 vs. 38.8 years, p < 0.001), more likely female (53.9 % vs. 47.4 %), and had higher smoking rates (49.3 % vs. 47.8 %). Urinary levels of CEMA, 3HPMA, HMPMA, 2HPMA, and X2MHA were significantly higher in osteoporosis groups (all p < 0.05). In adjusted models, dose-dependent risks were observed for higher quartiles of CEMA (Q4 OR: 32.38, 95 % CI: 26.32-39.84) and 3HPMA (Q4 OR: 254.02, 95 % CI: 149.16-432.58) (p < 0.001). Log-transformed VOC exposures, including HMPMA_log (OR: 1.22-1.33) and X2HPMA_log (OR: 3.87-4.08), further predicted osteoporosis risk. Subgroup analyses confirmed consistency across demographics, smoking status, and comorbidities.

CONCLUSION

Exposure to specific VOCs, including CEMA, 3HPMA, and X2MHA, may increase osteoporosis risk, highlighting the need for further research into their role in bone health.