AIR POLLUTION may silently weaken bones in postmenopausal women by disrupting specific metabolic processes, according to new findings from the Women’s Health Initiative (WHI) cohort.
The study is the first to examine how air pollutants like nitrogen dioxide (NO₂), nitrogen oxide (NO), and sulphur dioxide (SO₂) influence bone health through metabolic pathways. Researchers assessed bone mineral density (BMD) in postmenopausal women and analysed their plasma samples for metabolomic markers.
Using data from more than 9 years of follow-up, including dual-energy X-ray absorptiometry (DXA) scans and detailed environmental exposure mapping based on participants’ geocoded addresses, the study found that exposure to NO, NO₂, and SO₂ was consistently associated with metabolic changes involving taurine, inosine, and particularly a lipid known as C38:4 phosphatidylethanolamine (PE).
Importantly, mediation analysis showed that C38:4 PE partially explained the link between nitrogen oxide exposure and bone loss at the lumbar spine. This suggests that specific phospholipids may play a mediating role in how pollution contributes to skeletal deterioration.
While particulate matter ≤10 μm (PM10) was not found to have the same association, the identified gaseous pollutants appeared to have clear metabolic and skeletal effects over time.
“These findings highlight a potential biochemical mechanism by which environmental pollutants impact bone integrity,” the authors note, emphasising the significance for ageing populations at risk of osteoporosis.
Healthcare professionals may consider factoring in environmental exposures when assessing bone health in older women, particularly those living in areas with high traffic-related pollution. Further research is needed to explore interventions that could mitigate this risk.
Aleksandra Zurowska, EMJ
Reference
Prada D et al. Metabolomic Evaluation of Air Pollution-related Bone Damage and Potential Mediation in Women’s Health Initiative Participants. JBMR. 2025;DOI: 10.1093/jbmr/zjaf059.
