Metal(oid) profiling of the common site of osteoporotic fractures with bone microarchitecture correlation analysis: a comparative study of hip fracture patients and healthy individuals.

Increased urine and blood concentrations of heavy metals are linked to an elevated hip fracture risk, but studies dedicated to directly measuring metal(oid) concentrations in the femoral neck are limited. We investigated whether individuals with fractures exhibit a different pattern of metal(oid) bioaccumulation in the femoral neck and examined potential correlations between the concentrations of various metal(oid)s in the femoral neck and trabecular microarchitecture. To address these objectives, we collected femoral neck specimens from 23 individuals, namely 11 individuals with a positive history of contralateral hip fracture (9 women and 2 men, mean age 77.7 ± 8.1 years) and 12 individuals without fractures (10 women and 2 men, mean age 79.5 ± 5.6 years). All samples were subject to microcomputed tomography (micro-CT) to evaluate bone microarchitecture and inductively coupled plasma-mass spectrometry to determine tissue concentrations of metal(oid)s. In the fully adjusted model (adjusted for bone volume, age, and calcium tissue concentration), individuals with hip fractures exhibited higher aluminum levels (p = 0.047) and lower vanadium levels (p < 0.001). Individuals who sustained fragility fractures also showed lower BV/TV, Tb.Th, Tb.N, and higher Tb.Sp in the femoral neck trabeculae compared with the control group. Several different metal(oid)s were associated with altered patterns of trabecular microarchitecture. In summary, higher aluminum and lower vanadium concentrations in the trabeculae of the femoral neck provide a potential background for the gradual increase in fracture risk. Correlational analysis revealed an association between exposure to certain metals and deteriorated trabecular microarchitecture; however, larger studies are needed to determine the elements independently affecting bone microarchitecture.