{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:53:40Z","timestamp":1788386020225,"version":"build-2803163510"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T00:00:00Z","timestamp":1727827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006190","name":"Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006190","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Few observational studies have investigated the effect of micronutrients on osteomyelitis, and these findings are limited by confounding and conflicting results. Therefore, we conducted Mendelian randomization (MR) analyses to evaluate the association between blood levels of eight micronutrients (copper, selenium, zinc, vitamin B12, vitamin C, and vitamin D, vitamin B6, vitamin E) and the risk of osteomyelitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed the two-sample and multivariable Mendelian randomization (MVMR) to investigate causation, where instrument variables for the predictor (micronutrients) were derived from the summary data of micronutrients from independent cohorts of European ancestry. The outcome instrumental variables were used from the summary data of European-ancestry individuals (<jats:italic>n<\/jats:italic>\u2009=\u2009486,484). The threshold of statistical significance was set at <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.00625.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found a significant causal association that elevated zinc heightens the risk of developing osteomyelitis in European ancestry individuals OR\u2009=\u20091.23 [95% confidence interval (CI) [1.07, 1.43]; <jats:italic>p<\/jats:italic>\u2009=\u20094.26E-03]. Similarly, vitamin B6 showed a similar significant causal effect on osteomyelitis as a risk factor OR\u2009=\u20092.78 (95% CI [1.34, 5.76]; <jats:italic>p<\/jats:italic>\u2009=\u20096.04E-03; in the secondary analysis). <jats:italic>Post-hoc<\/jats:italic> analysis suggested this result (vitamin B6). However, the multivariable Mendelian randomization (MVMR) provides evidence against the causal association between zinc and osteomyelitis OR\u2009=\u20090.98(95% CI [\u22120.11, 0.07]; <jats:italic>p<\/jats:italic>\u2009=\u20097.20E-1). After searching in PhenoScanner, no SNP with confounding factors was found in the analysis of vitamin B6. There was no evidence of a reverse causal impact of osteomyelitis on zinc and vitamin B6.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study supported a strong causal association between vitamin B6 and osteomyelitis while reporting a dubious causal association between zinc and osteomyelitis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2024.1443539","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T04:37:14Z","timestamp":1727843834000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Circulating levels of micronutrients and risk of osteomyelitis: a Mendelian randomization study"],"prefix":"10.3389","volume":"11","author":[{"given":"Xu","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhimeng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binglong","family":"Xin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuixiang","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zitong","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yarui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,10,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/s0140-6736(04)16727-5","article-title":"Osteomyelitis","volume":"364","author":"Lew","year":"2004","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"3640","DOI":"10.1097\/00003086-198906000-00006","article-title":"Factors influencing infection rate in open fracture wounds","volume":"243","author":"Patzakis","year":"1989","journal-title":"Clin Orthop Relat Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1097\/BOT.0b013e31825d60e5","article-title":"Stress-induced Hyperglycemia as a risk factor for surgical-site infection in nondiabetic Orthopedic trauma patients admitted to the intensive care unit","volume":"27","author":"Richards","year":"2013","journal-title":"J Orthop Trauma"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e250","DOI":"10.1097\/oi9.0000000000000250","article-title":"Orthopaedic infections: what have we learned?","volume":"6","author":"Lee","year":"2023","journal-title":"OTA Int"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.5435\/jaaos-d-14-00394","article-title":"The economic significance of orthopaedic infections","volume":"23","author":"Hackett","year":"2015","journal-title":"J Am Acad Orthop Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1016\/j.arth.2015.01.017","article-title":"Medicare reimbursement attributable to Periprosthetic joint infection following primary hip and knee arthroplasty","volume":"30","author":"Yi","year":"2015","journal-title":"J Arthroplast"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.jcot.2015.04.004","article-title":"Surgical site infection in Orthopedic trauma: a case-control study evaluating risk factors and cost","volume":"6","author":"Thakore","year":"2015","journal-title":"J Clin Orthop Trauma"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"236","DOI":"10.3390\/nu12010236","article-title":"A review of micronutrients and the immune system-working in harmony to reduce the risk of infection","volume":"12","author":"Gombart","year":"2020","journal-title":"Nutrients"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1186\/s12891-015-0648-5","article-title":"May Osteoarticular infections be influenced by vitamin D status? 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