HDL cholesterol and bone mineral density in normal-weight postmenopausal women: is there any possible association?

Epidemiological investigation of the association between lipid profile, atherosclerosis and bone mass has produced conflicting

The present paper reports the assessment of the lipid profile, bone mineral density (BMD) and turnover in a cohort of Italian women.

In this cross sectional study we enrolled 173 women in menopause (101 osteoporotic and 72 normal). In each subject the authors evaluated BMD, bone turnover, lipid profile (total cholesterol, high density lipoprotein [HDL], low density lipoprotein [LDL] and triglycerides), and risk factors for osteoporosis, cardiovascular diseases and eating habits using a questionnaire.

HDL was significantly higher in osteoporotic patients than in controls and the risk of osteoporosis was significantly higher in women with higher level of HDL. The authors suggest that the level of HDL could be used as screening for postmenopausal osteoporosis: the cut-off points recommended are HDL >61 mg/dL to detect women with a high risk (sensitivity 74%) and <45 mg/dL to detect those with a low risk (specificity 83%).

This study provides evidences of the relation between HDL, but not total cholesterol or LDL levels with BMD in a cohort of normal-weight women and equally distributed cardiovascular risks. It also suggests that a proatherogenic lipid profile is associated with higher bone mineral density, and that HDL can be used in deciding whether a patient's BMD should be measured.