In vivo quantification of strontium in bone among adults using portable x-ray fluorescence.

BACKGROUND AND OBJECTIVE: Bone strontium (Sr) is a reliable biomarker for studying related bone health outcomes and the effectiveness of Sr supplements in osteoporosis disease treatment. In this study, we evaluated the sensitivity of portable x-ray fluorescence (XRF) technology for in vivo bone Sr quantification among adults. MATERIALS AND METHODS: Sr-doped bone-equivalent phantoms were used for system calibration. Using the portable XRF, we measured bone Sr levels in vivo in mid-tibia bone in 76 adults, 38-95 years of age, living in Indiana, US; we also analyzed bone data of 29 adults, 53-82 years of age, living in Shanghai, China. The same portable XRF device and system settings were used in measuring their mid-tibia bone. We compared bone Sr concentrations by sex, age, and recruitment site. We also used multiple linear regression model to estimate the association of age with bone Sr concentration, adjusting for sex and recruitment site. RESULTS: The uncertainty of in vivo individual measurement increased with higher soft tissue thickness overlying bone, and it ranged from 1.0 ug/g dry bone (ppm) to 2.4 ppm with thickness ranging from 2 to 7 mm, with a measurement time of 5 min. Geometric mean (95% confidence interval (CI)) of the bone Sr concentration was 79.1 (70.1, 89.3) ppm. After adjustment for recruitment site and sex, an increase in five years of age was associated with a 8.9% (95% CI: 2.5%, 15.6%) increase in geometric mean bone Sr concentration. DISCUSSION AND CONCLUSION: Sr concentrations were consistently well above detection limits of the portable XRF, and exhibited an expected increase with age. These data suggest that the portable XRF can be a valuable technology to quantify Sr concentration in bone, and in the study of Sr-related health outcomes among adults, such as bone mineral density (BMD) and bone fracture risk.

Association between blood metals mixtures concentrations and cognitive performance, and effect modification by diet in older US adults.

BACKGROUND: Chronic exposure to heavy metals has been associated with adverse neurological outcomes in older adults. Inflammatory processes are suspected as an underlying pathway by which metals exert their neurotoxicity. In parallel, a diet rich in antioxidant and anti-inflammatory components may protect against chronic inflammation. OBJECTIVES: We examined the associations of blood concentrations of lead, cadmium, and manganese as a mixture with cognitive performance in older US adults and potential modification of these associations by diet as measured by the Healthy Eating Index 2015 (HEI-2015) and the Adapted Dietary Inflammatory Index (ADII). METHODS: We used data on 1,777 adults ≥60 years old from the US National Health and Nutrition Examination Survey (NHANES; 2011-2014). We derived the ADII and the HEI-2015 from two nonconsecutive 24-hour diet recalls. Cognitive performance was measured by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word Learning subtest, the animal fluency test, and the Digit Symbol Substitution Test (DSST). We also constructed a composite z-score reflecting overall cognitive performance. We used quantile g-computation to evaluate the joint associations of a mixture of metals with cognitive performance test scores. We also evaluated effect modification by sex and diet quality indices using Cochran Q tests. RESULTS: The median (interquartile range) of blood metals were 0.38 µg/L (0.35), 14.70 µg/L (11.70), and 8.74 µg/L (4.06) for cadmium, lead, and manganese, respectively. Increasing blood concentrations of all metals by one quartile was associated with a decrease in overall cognitive performance (-0.04; 95% confidence interval [CI] = -0.09, 0.02), CERAD (-0.04; 95% CI = -0.12, 0.03), animal fluency (-0.02; 95% CI, -0.11, 0.06), and DSST (-0.05; 95% CI = -0.11, 0.02) test scores. These associations were more pronounced in adults with high pro-inflammatory or low-diet quality and null or positive though imprecise associations in participants with a high anti-inflammatory. These associations also varied by sex with inverse associations in men and positive associations in women. CONCLUSIONS: Our findings suggest that adherence to an antioxidant and anti-inflammatory diet may prevent blood metals adverse cognitive effects among older adults. If confirmed, strategies based on diet could provide a potential complementary and efficient approach to counteract effects of environmental pollutants.

A selenium species in cerebrospinal fluid predicts conversion to Alzheimer's dementia in persons with mild cognitive impairment.

BACKGROUND: Little is known about factors influencing progression from mild cognitive impairment to Alzheimer's dementia. A potential role of environmental chemicals and specifically of selenium, a trace element of nutritional and toxicological relevance, has been suggested. Epidemiologic studies of selenium are lacking, however, with the exception of a recent randomized trial based on an organic selenium form. METHODS: We determined concentrations of selenium species in cerebrospinal fluid sampled at diagnosis in 56 participants with mild cognitive impairment of nonvascular origin. We then investigated the relation of these concentrations to subsequent conversion from mild cognitive impairment to Alzheimer's dementia. RESULTS: Twenty-one out of the 56 subjects developed Alzheimer's dementia during a median follow-up of 42 months; four subjects developed frontotemporal dementia and two patients Lewy body dementia. In a Cox proportional hazards model adjusting for age, sex, duration of sample storage, and education, an inorganic selenium form, selenate, showed a strong association with Alzheimer's dementia risk, with an adjusted hazard ratio of 3.1 (95% confidence interval 1.0-9.5) in subjects having a cerebrospinal fluid content above the median level, compared with those with lower concentration. The hazard ratio of Alzheimer's dementia showed little departure from unity for all other inorganic and organic selenium species. These associations were similar in analyses that measured exposure on a continuous scale, and also after excluding individuals who converted to Alzheimer's dementia at the beginning of the follow-up. CONCLUSIONS: These results indicate that higher amounts of a potentially toxic inorganic selenium form in cerebrospinal fluid may predict conversion from mild cognitive impairment to Alzheimer's dementia.