Objective To investigate the effect of lead exposure on bone metabolism in human populations using a meta-analysis approach.

Methods The Chinese Journal Full-text Database, Wanfang Database, VIP Database, PubMed, and Web of Science were searched for the literature regarding the effect of lead exposure on bone metabolism indicators in human populations published up to March 2022. The retrieved studies were screened, and the data were extracted. The quality of the included studies was assessed using the Agency for Healthcare Research and Quality (AHRQ) cross-sectional study evaluation criteria. The analytical indicators of bone metabolism included vitamin D3, osteocalcin, and bone alkaline phosphatase (BALP). Stata 16 and Review Manager 5.3 were used for forest mapping, sensitivity analysis, and publication bias testing, with the standardized mean difference (SMD) and its 95% confidence interval (CI) as the effect indicators.

Results A total of 13 studies were included in this meta-analysis (n=2 029). The included studies showed a moderate to high degree of heterogeneity (I²>50%). Therefore, a random effects model was adopted. Compared with the population without lead exposure, the population with lead exposure showed significant differences (P < 0.01) with SMDs of -1.11 (95% CI: -2.20 to -0.02) for vitamin D3, -0.50 (95% CI: -0.91 to -0.09) for osteocalcin, and 0.80 (95% CI: 0.42 to 1.19) for BALP.

Conclusion The results of meta-analysis indicate that lead exposure has an effect on bone metabolism in human populations, characterized by increased levels of BALP and decreased levels of vitamin D3 and osteocalcin.