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

Purpose The association between aldehyde exposure and bone health in humans remains unclear. This study was to evaluate the association of serum aldehydes with bone mineral density (BMD) and osteopenia/osteoporosis. Methods We analyzed the US National Health and Nutrition Examination Survey cross-sectional data from 2013 to 2014. Weighted multivariate-adjusted linear regression and logistic regression models were used to assess the association between specific aldehydes and osteopenia/osteoporosis. Associations between aldehyde combinations and BMD were also evaluated using the restricted cubic spline (RCS) method. Results Compared with men in the first tertile, those in the third tertile of propanaldehyde concentration were negatively associated with proximal femur and lumbar spine BMD. Significant inverse associations were observed between benzaldehyde exposure and trochanter BMD in women. Benzaldehyde increased the risk of osteopenia/osteoporosis 2.75-fold [95% confidence interval (CI) = 1.06, 7.11] in the highest tertile in women compared to the lowest tertile concentration. In males, the prevalence of total femur, femur neck, and trochanter osteopenia/osteoporosis was significantly higher in the highest versus the lowest tertile of propanaldehyde exposure, with odds ratios (ORs) of 6.84 (95% CI = 2.33, 20.04), 2.72 (95% CI = 1.18, 6.27), and 3.26 (95% CI = 1.25, 8.56), respectively. RCS regression also showed decreased BMD continuously with increasing serum mixed aldehyde levels. Conclusions Serum aldehyde concentrations were associated with low BMD and high osteopenia/osteoporosis risk in adults, with propanaldehyde and benzaldehyde being the most critical. Co-exposure to aldehyde combinations was negatively correlated with BMD.