Endocrine Abstracts (2017) 49 EP744 | DOI: 10.1530/endoabs.49.EP744

Systematic screening for environmental and behavioral determinants identifies factors detrimental to skeletal health

Ling Oei1,2, Joy Wu3, Edwin Oei4, Fernando Rivadeneira2,5, Andre Uitterlinden2,5, John Ioannidis6, Michael Snyder1 & Chirag Patel7

1Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA; 2Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands; 3Division of Endocrinology, Stanford University School of Medicine, Stanford, CA, USA; 4Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands; 5Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands; 6Stanford University School of Medicine, Stanford Prevention Research Center, USA; 7Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.

Background: An increasing amount of biomedical data is becoming available, and methods are needed to tackle these “big data”.

Methods: We performed a systematic evaluation of 138 environmental and behavioral factors in relation to bone mineral density (BMD) in the National Health and Nutrition Examination Survey (NHANES). Dual energy X-ray absorptiometry (DXA) scans were available for total body, head, pelvis and lumbar spine for 27,259 participants from NHANES surveys 1999–2000 (A), 2001–2002 (B), 2003–2004 (C) and 2005–2006 (D). A discovery Environment-Wide Association Study (EWAS) was performed on cohorts B and D, and replication was sought in cohorts A and C.

Results: Higher serum levels of a-tocopherol (per S.D. β=−0.25% for lumbar spine) and of g-tocopherol (β=−0.54% for total body), forms of vitamin E, were associated with decreased BMD. In contrast, retinol serum levels were related to higher BMD (per S.D. β=+0.21% for total body). Serum lead levels had a negative relationship to BMD of the lumbar spine (per S.D. β=−0.43%) and head (per S.D. β=−0.87%). Higher levels of physical activity were associated with higher BMD (total body: per MET +1.2%). Being a current or past smoker was associated with decreased BMD of the total body, pelvis and head.

Conclusion: In conclusion, our study demonstrates consistently that several behavioral traits and fat-soluble vitamins may have detrimental effects on BMD, while reinforcing the benefit of physical activity for skeletal health.

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