Related Experiment Video
Updated: Jun 13, 2025
Dynamic Multiparameter Platelet Function Assessment Using a Capacitive Biosensor
Published on: May 2, 2025
Non-linear association of the platelet/high-density lipoprotein cholesterol ratio with bone mineral density a
Haobo Ye1, Zihao Chen1, Kaiyu Li1
1Department of Orthopaedic Surgery, The Second Affiliated Hospital, Yuying Children Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
Insights
The platelet to HDL-C ratio (PHR) shows an inverted U-shaped link with bone mineral density (BMD). Maintaining optimal PHR is crucial for bone health, particularly in at-risk individuals.
Area of Science:
- Biomedical science
- Bone metabolism
- Cardiovascular health
Background:
- Osteoporosis and cardiovascular disease share risk factors and mechanisms.
- Platelets and HDL-C are key to cardiovascular health; their ratio (PHR) is a novel biomarker.
- PHR may indicate inflammatory states and bone resorption, but its link to BMD is unclear.
Purpose of the Study:
- To investigate the relationship between the platelet to HDL-C ratio (PHR) and bone mineral density (BMD).
Main Methods:
- Analysis of NHANES 2005-2018 data from 13,936 adults.
- Utilized smoothed curves, generalized additive models, and threshold effect analysis.
- Conducted subgroup and interaction analyses for age and sex.
Main Results:
- A nonlinear, inverted U-shaped relationship was found between PHR and total femur BMD.
- A significant negative association between PHR and BMD was observed beyond a PHR of 33.301.
- Significant interactions were noted in age and sex subgroups.
Conclusions:
- A complex, nonlinear, inverted U-shaped relationship exists between PHR and total femur BMD.
- Optimal PHR levels are important for maintaining bone health.
- Findings are particularly relevant for high-risk populations.
Background:
Numerous studies have demonstrated shared risk factors and pathophysiologic mechanisms between osteoporosis and cardiovascular disease. High-density lipoprotein cholesterol (HDL-C) and platelets have long been recognized as crucial factors for cardiovascular health. The platelet to HDL-C ratio (PHR) combines platelet count and high-density lipoprotein cholesterol (HDL-C) level, It is a novel biomarker for metabolic syndrome and cardiovascular disease. The platelet to HDL-C ratio (PHR) possibly reflects the balance between proinflammatory and anti-inflammatory states in the body. Therefore, we hypothesized that changes in PHR ratios may predict a predisposition to pro-inflammatory and increased bone resorption. However, the relationship between the platelet to HDL-C ratio (PHR) and bone mineral density (BMD) remains insufficiently understood. This study aimed to elucidate the relationship between the platelet to HDL-C ratio (PHR) index and bone mineral density (BMD).
Methods:
Data from the NHANES 2005-2018 were analyzed, excluding adults with missing key variables and specific conditions. Nonlinear relationships were explored by fitting smoothed curves and generalized additive models, with threshold effects employed to calculate inflection points. Additionally, subgroup analyses and interaction tests were conducted.
Results:
The study included 13,936 individuals with a mean age of 51.19 ± 16.65 years. Fitted smoothed curves and generalized additive models revealed a nonlinear, inverted U-shaped relationship between the two variables. Threshold effect analysis showed a significant negative association between PHR and total femur bone mineral density (BMD) beyond the inflection point of platelet to HDL-C ratio (PHR) 33.301. Subgroup analyses showed that a significant interaction between these two variables was observed only in the age and sex subgroups (P-interaction < 0.05).
Conclusions:
Our study identified a complex, nonlinear, inverted U-shaped relationship between platelet to HDL-C ratio (PHR) and total femur bone mineral density (BMD). These findings underscore the importance of maintaining optimal PHR levels to support bone health, especially in high-risk populations.
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