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High-density Lipoprotein Cholesterol Is Negatively Correlated with Bone Mineral Density and Has Potential Predictive
Yuchen Tang1,2,3, Shenghong Wang1,2,3, Qiong Yi1,2,3
1Department of Orthopaedics, Lanzhou University Second Hospital, #82 Cuiyingmen, Lanzhou, Gansu, People's Republic of China, 730000.
Insights
High-density lipoprotein cholesterol (HDL-C) shows an inverse association with bone mineral density (BMD), particularly in women. Elevated HDL-C may signal increased risk for osteopenia and osteoporosis, necessitating monitoring.
Area of Science:
- Endocrinology
- Bone Metabolism
- Lipidology
Background:
- Lipids are crucial for bone metabolism, but the link between high-density lipoprotein cholesterol (HDL-C) and bone mineral density (BMD) remains unclear.
- Understanding this relationship is vital for assessing osteoporosis and osteopenia risks.
Purpose of the Study:
- To investigate the linear and nonlinear associations between HDL-C levels and BMD.
- To determine if HDL-C levels can predict the risk of osteoporosis or osteopenia.
Main Methods:
- Analysis of National Health and Nutrition Examination Survey (NHANES) data for adults over 20.
- Multivariate linear regression and generalized additive models to assess linear and nonlinear relationships.
- Multiple logistic regression to evaluate odds ratios for osteopenia and osteoporosis.
Main Results:
- HDL-C levels showed an inverse association with BMD, especially in females and specific age groups (30-39, 50-59).
- Nonlinear relationships included inverted U-shaped and U-shaped associations between HDL-C and BMD in women across different age brackets.
- High HDL-C levels (62-139 mg/dL) in females correlated with an increased risk of osteopenia or osteoporosis.
Conclusions:
- HDL-C levels are inversely correlated with BMD, with significant implications for women's bone health.
- Elevated HDL-C in females may indicate a higher risk of developing osteopenia or osteoporosis.
- Close BMD monitoring and early intervention are recommended for individuals with high HDL-C levels.
Background:
Many studies have shown that lipids play important roles in bone metabolism. However, the association between high-density lipoprotein cholesterol (HDL-C) and bone mineral density (BMD) is unclear. Therefore, this study aimed to investigate the linear or nonlinear relation between HDL-C levels and BMD and addressed whether the HDL-C levels had the potential values for predicting the risk of osteoporosis or osteopenia.
Methods:
Two researchers independently extracted all information from the National Health and Nutrition Examination Survey (NHANES) database. Participants over 20 years of age with available HDL-C and BMD data were enrolled in the final analysis. The linear relationship between HDL-C levels and BMD was assessed using multivariate linear regression models. Moreover, the nonlinear relationship was also characterized by fitted smoothing curves and generalized additive models. In addition, the odds ratio (OR) for osteopenia and osteoporosis was evaluated with multiple logistic regression models.
Results:
The weighted multivariable linear regression models demonstrated that HDL-C levels displayed an inverse association with BMD, especially among females and subjects aged 30 to 39 or 50 to 59. Moreover, the nonlinear relationship characterized by smooth curve fittings and generalized additive models suggested that (i) HDL-C levels displayed an inverted U-shaped relationship with BMD among women 30 to 39 or over 60 years of age; (ii) HDL-C levels exhibited a U-shaped association with BMD among women 20 to 29 or 50 to 59 years of age. In addition, females with high HDL levels (62-139 mg/dL) had an increased risk of osteopenia or osteoporosis.
Conclusion:
This study demonstrated that HDL-C levels exhibit an inverse correlation with BMD. Especially in females, clinicians need to be alert to patients with high HDL-C levels, which may indicate an increased risk of osteoporosis or osteopenia. For these patients, close monitoring of BMD and early intervention may be necessary.
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