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 Lead May Be the Bullet Causing Osteoporosis in
Senior Citizens
March 27, 2006 - A growing body of research is
putting yet one more notch in the belt of diseases attributed to lead,
and this time, researchers say, its target is older adults at risk for
osteoporosis. Bolstered by recent laboratory findings, researchers at
the University of Rochester Medical Center are embarking on a National
Institutes of Health-funded clinical study to better understand the
deceptive role environmental lead exposure plays in bone maturation and
loss.
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Health & Medicine |
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For decades, scientists have known that the human
skeleton is a repository for lead in people who were exposed to high
levels of this environmental toxin in their childhood, but thought this
storage to be benign. Recently, a growing body of research is showing
that the opposite is true, and that lead in bone actually sets off a
bizarre chain reaction, first accelerating bone growth, and then
eventually limiting it so that a high peak bone mass is not achieved.
Preventing a high peak bone mass will predispose a young person to
osteoporosis later in life.
Now, researchers in the Center for Musculoskeletal
Research at the University of Rochester Medical Center are set to embark
on the next phase of a four-year, $5 million research project funded by
the National Institute of Environmental Health Sciences with a clinical
study aimed at better understanding the deceptive role lead initially
plays in bone development, growth and loss – and how this all might lead
to earlier onset of osteoporosis in those exposed to high levels of lead
as a child.
A metabolic bone disease that predominantly occurs
in women, osteoporosis affects one in three American women over the age
of 65. It is characterized by low bone mass that eventually leads to
fractures, mostly of the hip and vertebrae. These fractures can be
life-threatening; experts say that more women die each year from hip
fracture complications than from cancer of the ovaries, cervix and
uterus combined. Close to $20 billion dollars is spent each year
treating osteoporosis and related fractures.
An Ironic Growth Pattern
The pattern of growth in the skeleton determines
the peak skeletal density of an individual, and this level is
established by the time most people reach 20. Recent research completed
at the University of Rochester Medical Center shows that lead adversely
affects the normal maturation of the growth plate – but does so in an
odd way.
"As a child, lead appears to accelerate bone
development and maturation, so that lead-exposed children actually have
a higher bone density than those not exposed to environmental lead,"
said James Campbell, M.D., M.P.H., associate professor of Pediatrics and
a co-investigator of the study. "But, we believe this higher bone
density effect is short-lived, and in fact, we believe it actually
prevents these children from achieving an optimal peak bone mass later
on in life."
J. Edward Puzas, Ph.D., professor of Orthopaedics
and director of the overall project, added that limiting peak bone mass
has dire consequences as a person begins to age.
"When everyone begins to lose bone mass starting at
around age 50, lead-exposed individuals are at a higher risk for bone
fractures and osteoporosis – and probably at an earlier age than the
typical osteoporosis patient."
At what specific age lead-exposed individuals will
plateau in bone growth, and at what age they will begin to lose more
bone as older adults, is the focus of this clinical research. Puzas and
Campbell have used their prior research to guesstimate when these two
milestones occur, but are turning to sophisticated lead measurement
devices to help them pinpoint exact timeframes.
"We believe that somewhere around age 20, we'll
begin to see low-lead exposed individuals surpass high-lead exposed
individuals in bone mass density," Campbell said. "Then, in the 50 to 60
age group – the age at which any individuals will begin to experience a
natural loss of bone – we expect to see the high-lead exposed
individuals losing more bone sooner."
An X-ray fluorescence spectrometer will be used to
measure the bone lead levels in 500 people, separated into three age
groups: 8-9 years old, 18-19 years old, and 50-60 years old. One of only
a few installed machines worldwide, it provides a precise, noninvasive
measurement of the historic accumulated exposure to lead, allowing
researchers to place each of the research subjects into an either
"low-lead exposure" or "high-lead exposure" category within their age
groups. A DEXA-scan will then be used to measure bone density, and with
these data in hand, the investigators will have a better sense of when
lead-exposed individuals might begin to experience osteoporotic
symptoms.
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