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Xu B, Ma G, Yang L, Chen X, Bian B, Yang B, Zhang D, Qin X, Zhu L, Yin H, Wei X, Feng M. Non-linear association of atherogenic index of plasma with bone mineral density a cross-sectional study. Lipids Health Dis 2024; 23:181. [PMID: 38867213 PMCID: PMC11167925 DOI: 10.1186/s12944-024-02180-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/07/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION Although there has been abundant evidence of the association between dyslipidemia as a single factor and osteoporosis, the non-linear relationship between osteoporosis and the Atherogenic Index of Plasma (AIP) has not yet been thoroughly investigated. This study aimed to investigate the complex relationship between AIP and bone mineral density (BMD) to elucidate their interrelationship. METHODS An analysis of 2007-2018 National Health and Nutrition Survey (NHANES) data was conducted for this study. The study enrolled 5,019 participants. Logarithmically multiplying triglycerides and high-density lipoprotein cholesterol yields the AIP (base 10). The measured variables consisted of BMD in the total femur (TF), femoral neck (FN), and lumbar spine (LS). The association between AIP and BMD was examined using a range of statistical models, such as weighted multivariable logistic regression, generalized additive model, etc. RESULTS: It was found that AIP was positively associated with BMD after adjusting for age, gender, race, socioeconomic status, degree of education, income, Consuming alcoholic beverages, osteoporosis status (Yes or No), ALT, AST, serum creatinine, and total calcium levels. Further studies supported the association link between elevated BMD and AIP. Furthermore, compared to men, females had a higher positive connection between AIP and BMD. In general, there was a curve in the reverse L-shape seen, with a point of change around 0.877, indicating a relationship between AIP and TF BMD. Moreover, a curve exhibiting an L-formed pattern, with a point of inflection at around 0.702, was seen between AIP and FN BMD. In addition, a J-shaped curve was seen, with a point of inflection at 0.092, which demonstrates the association between AIP and LS BMD. CONCLUSION The AIP and TF BMD curves resemble inverted L shapes, as do the AIP and FN BMD curves. The relationship between AIP and LS BMD was further demonstrated by a J-shaped curve. The results indicate a possible association between AIP and bone mineral density, which should be explored in more detail.
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Affiliation(s)
- Bo Xu
- Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100000, China
| | - Guoliang Ma
- Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100000, China
| | - Liu Yang
- Department of Dermatology, Guanganmen Hospital, China Academy of Chinese, Medical Sciences, Beijing, China
| | - Xin Chen
- Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100000, China
| | - Bo Bian
- Traditional Chinese Medical College, North China University of Science and Technology, Tangshan, Hebei, China
| | - Bowen Yang
- Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100000, China
| | - Dian Zhang
- Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100000, China
| | - Xiaokuan Qin
- Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100000, China
| | - Liguo Zhu
- Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100000, China
- Beijing Key Laboratory of Bone Setting Technology of Traditional Chinese Medicine, Beijing, China
| | - He Yin
- Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100000, China.
| | - Xu Wei
- Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100000, China.
| | - Minshan Feng
- Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100000, China.
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Tan MY, Zhu SX, Wang GP, Liu ZX. Impact of metabolic syndrome on bone mineral density in men over 50 and postmenopausal women according to U.S. survey results. Sci Rep 2024; 14:7005. [PMID: 38523143 PMCID: PMC10961310 DOI: 10.1038/s41598-024-57352-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024] Open
Abstract
Metabolic Syndrome (MetS) and bone mineral density (BMD) have shown a controversial link in some studies. This research aims to study their association in males over 50 and postmenopausal females using National Health and Nutrition Examination Survey (NHANES) data. Postmenopausal females and males over 50 were included in the study. MetS was defined by the National Cholesterol Education Program Adult Treatment Panel III guidelines. BMD values were measured at the thoracic spine, lumbar spine, and pelvis as the primary outcome. Weighted multivariate general linear models have been employed to explore the status of BMD in patients with MetS. Additionally, interaction tests and subgroup analyses were conducted. Utilizing the NHANES database from 2003 to 2006 and 2011-2018, we included 1924 participants, with 1029 males and 895 females. In postmenopausal women, after adjusting for covariates, we found a positive correlation between MetS and pelvic (β: 0.030 [95%CI 0.003, 0.06]) and thoracic (β: 0.030 [95%CI 0.01, 0.06]) BMD, though not for lumbar spine BMD (β: 0.020 [95%CI - 0.01, 0.05]). In males over 50 years old, MetS was positively correlated with BMD in both Model 1 (without adjusting for covariates) and Model 2 (considering age and ethnicity). Specifically, Model 2 revealed a positive correlation between MetS and BMD at the pelvis (β: 0.046 [95%CI 0.02, 0.07]), thoracic spine (β: 0.047 [95%CI 0.02, 0.07]), and lumbar spine (β: 0.040 [95%CI 0.02, 0.06]). Subgroup analysis demonstrated that the relationship between MetS and BMD remained consistent in all strata, underscoring the stability of the findings. In postmenopausal women, after adjusting for all covariates, a significant positive correlation was observed between MetS and BMD in the pelvis and thoracic spine, whereas this correlation was not significant for lumbar spine BMD. Conversely, in males, positive correlations between MetS and BMD at the lumbar spine, thoracic spine, and pelvis were identified in Model 2, which adjusted for age and ethnicity; however, these correlations disappeared after fully adjusting for all covariates. These findings highlight the potential moderating role of gender in the impact of MetS on BMD.
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Affiliation(s)
- Mo-Yao Tan
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Si-Xuan Zhu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Gao-Peng Wang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhong-Xing Liu
- Dujiangyan Traditional Chinese Medicine Hospital, Chengdu, Sichuan, China.
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Sun Y, Qi X, Wang X, Lin X, Zhou Y, Du Y, Liu A, Lv X, Zhou J, Li Z, Wu X, Zou Z, Zhang M, Zhu J, Shang F, Li Y, Li H. Association between high-density lipoprotein cholesterol and lumbar bone mineral density in Chinese: a large cross-sectional study. Lipids Health Dis 2024; 23:27. [PMID: 38267987 PMCID: PMC10807139 DOI: 10.1186/s12944-024-02023-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/17/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND The association between lipid and bone metabolism, particularly the role of high-density lipoprotein cholesterol (HDL-C) in regulating bone mineral density (BMD), is of significant interest. Despite numerous studies, findings on this relationship remain inconclusive, especially since evidence from large, sexually diverse Chinese populations is sparse. This study, therefore, investigates the correlation between HDL-C and lumbar BMD in people of different genders using extensive population-based data from physical examinations conducted in China. METHODS Data from a cross-sectional survey involving 20,351 individuals aged > = 20 years drawn from medical records of health check-ups at the Health Management Centre of the Henan Provincial People's Hospital formed the basis of this study. The primary objective was to determine the correlation between HDL-C levels and lumbar BMD across genders. The analysis methodology included demographic data analysis, one-way ANOVA, subgroup analyses, multifactorial regression equations, smoothed curve fitting, and threshold and saturation effect analyses. RESULTS Multifactorial regression analysis revealed a significant inverse relationship between HDL-C levels and lumbar BMD in both sexes, controlling for potential confounders (Male: β = -8.77, 95% CI -11.65 to -5.88, P < 0.001; Female: β = -4.77, 95% CI -8.63 to -0.90, P = 0.015). Subgroup and threshold saturation effect analyses indicated a stronger association in males, showing that increased HDL-C correlates with reduced lumbar BMD irrespective of age and body mass index (BMI). The most significant effect was observed in males with BMI > 28 kg/m2 and HDL-C > 1.45 mmol/L and in females with a BMI between 24 and 28 kg/m2. CONCLUSION Elevated HDL-C is associated with decreased bone mass, particularly in obese males. These findings indicate that individuals with high HDL-C levels should receive careful clinical monitoring to mitigate osteoporosis risk. TRIAL REGISTRATION The research protocol received ethics approval from the Ethics Committee at Beijing Jishuitan Hospital, in conformity with the Declaration of Helsinki guidelines (No. 2015-12-02). These data are a contribution of the China Health Quantitative CT Big Data Research team, registered at clinicaltrials.gov (code: NCT03699228).
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Affiliation(s)
- Yongbing Sun
- Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China
| | - Xin Qi
- Department of Medical Imaging, Henan Provincial People's Hospital, Xinxiang Medical College, Zhengzhou, Henan, 450003, China
| | - Xuan Wang
- Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University, #7 Kungfu Street, Zhengzhou, Henan, 450052, China
| | - Xinbei Lin
- Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China
| | - Yang Zhou
- Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China
| | - Yawei Du
- Department of Medical Imaging, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Ao Liu
- Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China
| | - Xue Lv
- Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Jing Zhou
- Department of Health Management, Chronic Health Management Laboratory, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Zhonglin Li
- Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China
| | - Xiaoling Wu
- Department of Nuclear Medicine, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Zhi Zou
- Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China
| | - Michael Zhang
- Sevenoaks Health Management Center, Canada-Canada Institute of Health Engineering, University of Manitoba, Winnipeg, Canada
| | - Jiadong Zhu
- Department of Health Management, Chronic Health Management Laboratory, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Feifei Shang
- Department of Health Management, Chronic Health Management Laboratory, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Yongli Li
- Department of Health Management, Chronic Health Management Laboratory, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China.
| | - Hao Li
- Fuwaihua Central Vascular Disease Hospital, #1 Fuwai Avenue, Zhengzhou, Henan, 451464, China.
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Kang J, Zhao S, Wu X, Wang C, Jiang Z, Wang S. The association of lipid metabolism with bone metabolism and the role of human traits: a Mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1271942. [PMID: 38125793 PMCID: PMC10731031 DOI: 10.3389/fendo.2023.1271942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
Background The impact of lipid metabolism on bone metabolism remains controversial, and the extent to which human traits mediate the effects of lipid metabolism on bone metabolism remains unclear. Objective This study utilized mendelian randomization to investigate the effects of blood lipids on bone mineral density (BMD) at various skeletal sites and examined the mediating role of human traits in this process. Methods We leveraged genetic data from large-scale genome-wide association studies on blood lipids (n=1,320,016), forearm bone mineral density (FA-BMD) (n=10,805), lumbar spine bone mineral density (LS-BMD) (n=44,731), and femoral neck bone mineral density (FN-BMD) (n=49,988) to infer causal relationships between lipid and bone metabolism. The coefficient product method was employed to calculate the indirect effects of human traits and the proportion of mediating effects. Results The results showed that a 1 standard deviation(SD) increase in HDL-C, LDL-C and TC was associated with a decrease in LS-BMD of 0.039 g/cm2, 0.045 g/cm2 and 0.054 g/cm2, respectively. The proportion of mediating effects of systolic blood pressure (SBP) on HDL-C to LS-BMD was 3.17%, but suppression effects occurred in the causal relationship of LDL-C and TC to LS-BMD. Additionally, the proportion of mediating effects of hand grip strength (HGS) on the TC to LS-BMD pathway were 6.90% and 4.60% for the left and right hands, respectively. Conclusion In conclusion, a negative causal relationship was established between lipid metabolism and bone metabolism. Our results indicated that SBP and HGS served as mediators for the effects of lipid metabolism on bone metabolism.
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Affiliation(s)
- Jian Kang
- Graduate School, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Shuangli Zhao
- Orthopedics and Traumatology, The Second Hospital of Liaoning University of Chinese Medicine, Shenyang, China
| | - Xize Wu
- Department of Critical Care Medicine, Nantong Hospital of Traditional Chinese Medicine, Nantong, China
| | - Can Wang
- Clinical College, Jinzhou Medical University, Jinzhou, China
| | - Zongkun Jiang
- Orthopedics and Traumatology, The Second Hospital of Liaoning University of Chinese Medicine, Shenyang, China
| | - Shixuan Wang
- Orthopedics and Traumatology, The Second Hospital of Liaoning University of Chinese Medicine, Shenyang, China
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Zhao X, Tan N, Zhang Y, Xiao M, Li L, Ning Z, Liu M, Jin H. Associations between apolipoprotein B and bone mineral density: a population-based study. BMC Musculoskelet Disord 2023; 24:861. [PMID: 37919727 PMCID: PMC10621203 DOI: 10.1186/s12891-023-06990-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Lipids are critical in bone metabolism, and several studies have highlighted their importance. This study aimed to investigate the relationship between apolipoprotein B (apo B) and bone mineral density (BMD) at different skeletal sites (lumbar spine, femoral neck, and total femur) and to compare the influence of apo B with other traditional lipid markers. METHODS The study included participants from the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2016 who had complete data for apo B and BMD at the three skeletal sites. We used weighted multivariate regression analysis, subgroup analysis, and interaction tests to examine associations. Restricted cubic spline (RCS) was used to examine the non-linear relationship. RESULTS A total of 4,258 adults were included in the study. Multivariate linear regression analysis showed that the relationship between apo B and BMD varied by skeletal site: a negative association was found with lumbar spine BMD [β = -0.054, 95%CI: (-0.073, -0.035)]. In contrast, a positive association was found with femoral neck BMD [β = 0.031, 95%CI: (0.011, 0.051)] and no significant association between apo B and total femur BMD. CONCLUSIONS Our findings suggest that apo B is associated with BMD in a site-specific manner.
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Affiliation(s)
- Xuefei Zhao
- Department of Spine Surgery, The Affiliated Second Hospital, Hengyang Medical School, University of South China, Hengyang, 421009, China
| | - Ning Tan
- Department of Urology, The Affiliated Second Hospital, Hengyang Medical School, University of South China, Hengyang, 421009, China
| | - Ya Zhang
- Department of Gland Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, 421002, China
| | - Mengde Xiao
- Department of Gland Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, 421002, China
| | - Lihong Li
- Department of Gland Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, 421002, China
| | - Zhongxing Ning
- Department of Intensive Care Unit, The People's Hospital of Guangxi Zhuang Autonomous Region & Research Center of Intensive Care Unit, Nanning, 530021, China
| | - Mingjiang Liu
- Department of Hand & Microsurgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, 421002, China
| | - Haimin Jin
- Department of Neurology, Wenzhou Central Hospital, Dingli Clinical Institute of Wenzhou Medical University, Wenzhou, 325000, China.
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Zhan H, Liu X, Piao S, Rong X, Guo J. Association between triglyceride-glucose index and bone mineral density in US adults: a cross sectional study. J Orthop Surg Res 2023; 18:810. [PMID: 37904197 PMCID: PMC10614394 DOI: 10.1186/s13018-023-04275-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/10/2023] [Indexed: 11/01/2023] Open
Abstract
OBJECTIVE Disorders in glucose and lipid metabolism have been shown to exert an influence on bone metabolism. The TyG index, which combines measures of glucose and triglycerides, provides insights into the overall metabolic status. However, the investigation of concurrent disturbances in glucose and lipid metabolism and their specific implications for bone metabolism remains limited in the existing research literature. This study aimed to explore the correlation between the TyG index and bone mineral density (BMD) in US adults. METHODS In the National Health and Nutrition Examination Survey (NHANES), subjects were classified based on the TyG index into four groups (< 7.97, 7.97-8.39, 8.39-8.85, > 8.86). Linear regression analysis was conducted to determine the β value and 95% confidence interval (CI). Four multivariable models were constructed. Restricted cubic spline analyses and piecewise linear regression were employed to identify the association between the BMD and TyG index. An analysis of subgroups was also conducted in this study. RESULTS Significant variations in related characteristics were found among the US adult population, who were distributed into four groups based on the quartiles of the TyG index. A negative correlation between the TyG index and lumbar spine BMD was observed. In the multi-adjusted models, compared to Q1 of the TyG index, the β for Q4 of the TyG index for lumbar spine BMD was [β = - 0.008, 95% CI (- 0.017, 0)] in US adults. The association between the TyG index and lumbar spine BMD was found to be nonlinear (all nonlinear p < 0.001), with a threshold value based on restricted cubic spline analyses. Above the threshold point, the β for lumbar spine BMD was - 0.042 (95% CI, - 0.059, - 0.024). Below the threshold points, no significant difference was observed (p > 0.05). No significant interactions were observed among subgroups based on age, gender, presence of diabetes, BMI, and use of antidiabetic and antihyperlipidemic agents. Similar patterns of association were observed in total and subtotal bone density. CONCLUSIONS This study identified a nonlinear association between the TyG index and BMD in the US population. Furthermore, an increased level of the TyG index may indicate a higher risk of osteoporosis among US adults. These findings highlight the importance of considering glucose and lipid metabolism disturbances in understanding bone health and the potential for developing preventive strategies for osteoporosis.
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Affiliation(s)
- Huixia Zhan
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangzhou, China
- Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangzhou, China
- Guangdong TCM Key Laboratory for Metabolic Diseases, Guangzhou, China
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Xinyu Liu
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangzhou, China
- Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangzhou, China
- Guangdong TCM Key Laboratory for Metabolic Diseases, Guangzhou, China
- The Institute of Chinese Medicinal Sciences, Guangdong Pharmaceutical University, Guangzhou, China
| | - Shenghua Piao
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangzhou, China
- Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangzhou, China
- Guangdong TCM Key Laboratory for Metabolic Diseases, Guangzhou, China
- The Institute of Chinese Medicinal Sciences, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xianglu Rong
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangzhou, China
- Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangzhou, China
- Guangdong TCM Key Laboratory for Metabolic Diseases, Guangzhou, China
- The Institute of Chinese Medicinal Sciences, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jiao Guo
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangzhou, China.
- Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangzhou, China.
- Guangdong TCM Key Laboratory for Metabolic Diseases, Guangzhou, China.
- The Institute of Chinese Medicinal Sciences, Guangdong Pharmaceutical University, Guangzhou, China.
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Galvez-Fernandez M, Rodriguez-Hernandez Z, Grau-Perez M, Chaves FJ, Garcia-Garcia AB, Amigo N, Monleon D, Garcia-Barrera T, Gomez-Ariza JL, Briongos-Figuero LS, Perez-Castrillon JL, Redon J, Tellez-Plaza M, Martin-Escudero JC. Metabolomic patterns, redox-related genes and metals, and bone fragility endpoints in the Hortega Study. Free Radic Biol Med 2023; 194:52-61. [PMID: 36370960 DOI: 10.1016/j.freeradbiomed.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/06/2022] [Accepted: 11/06/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The potential joint influence of metabolites on bone fragility has been rarely evaluated. We assessed the association of plasma metabolic patterns with bone fragility endpoints (primarily, incident osteoporosis-related bone fractures, and, secondarily, bone mineral density BMD) in the Hortega Study participants. Redox balance plays a key role in bone metabolism. We also assessed differential associations in participant subgroups by redox-related metal exposure levels and candidate genetic variants. MATERIAL AND METHODS In 467 participants older than 50 years from the Hortega Study, a representative sample from a region in Spain, we estimated metabolic principal components (mPC) for 54 plasma metabolites from NMR-spectrometry. Metals biomarkers were measured in plasma by AAS and in urine by HPLC-ICPMS. Redox-related SNPs (N = 341) were measured by oligo-ligation assay. RESULTS The prospective association with incident bone fractures was inverse for mPC1 (non-essential and essential amino acids, including branched-chain, and bacterial co-metabolites, including isobutyrate, trimethylamines and phenylpropionate, versus fatty acids and VLDL) and mPC4 (HDL), but positive for mPC2 (essential amino acids, including aromatic, and bacterial co-metabolites, including isopropanol and methanol). Findings from BMD models were consistent. Participants with decreased selenium and increased antimony, arsenic and, suggestively, cadmium exposures showed higher mPC2-associated bone fractures risk. Genetic variants annotated to 19 genes, with the strongest evidence for NCF4, NOX4 and XDH, showed differential metabolic-related bone fractures risk. CONCLUSIONS Metabolic patterns reflecting amino acids, microbiota co-metabolism and lipid metabolism were associated with bone fragility endpoints. Carriers of redox-related variants may benefit from metabolic interventions to prevent the consequences of bone fragility depending on their antimony, arsenic, selenium, and, possibly, cadmium, exposure levels.
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Affiliation(s)
- Marta Galvez-Fernandez
- Department of Preventive Medicine and Microbiology, School of Medicine, Universidad Autónoma de Madrid, Arzobispo Morcillo, 4, 28029, Madrid, Spain; Department of Preventive Medicine, Hospital Universitario Severo Ochoa, Avenida de Orellana, s/n, 28911, Madrid, Spain; Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Instituto de Salud Carlos III, Monforte de Lemos, 5, 28029, Madrid, Spain
| | - Zulema Rodriguez-Hernandez
- Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Instituto de Salud Carlos III, Monforte de Lemos, 5, 28029, Madrid, Spain; Department of Biotechnology, Universitat Politècnica de València, Camí de Vera, s/n, 46022, Valencia, Spain
| | - Maria Grau-Perez
- Department of Preventive Medicine and Microbiology, School of Medicine, Universidad Autónoma de Madrid, Arzobispo Morcillo, 4, 28029, Madrid, Spain; INCLIVA Biomedical Research Institute, Menéndez y Pelayo, 4, 46010, Valencia, Spain
| | - F Javier Chaves
- INCLIVA Biomedical Research Institute, Menéndez y Pelayo, 4, 46010, Valencia, Spain; CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain
| | - Ana Barbara Garcia-Garcia
- INCLIVA Biomedical Research Institute, Menéndez y Pelayo, 4, 46010, Valencia, Spain; CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain
| | - Nuria Amigo
- Biosfer Teslab, Plaça de Prim, 10, 43201, Tarragona, Spain; Department of Basic Medical Sciences, Universidad de Rovira I virgili, Carrer de Sant Llorenç, 21, 43201, Tarragona, Spain
| | - Daniel Monleon
- INCLIVA Biomedical Research Institute, Menéndez y Pelayo, 4, 46010, Valencia, Spain; Department of Pathology, School of Medicine, Universidad de Valencia, Avenida de Blasco Ibáñez, 15, 46010, Valencia, Spain; Center for Biomedical Research Network on Frailty and Health Aging (CIBERFES), Madrid, Spain
| | - Tamara Garcia-Barrera
- Department of Chemistry, Universidad de Huelva, Avenida de las Fuerzas Armadas, 21007, Huelva, Spain
| | - Jose L Gomez-Ariza
- Department of Chemistry, Universidad de Huelva, Avenida de las Fuerzas Armadas, 21007, Huelva, Spain
| | - Laisa S Briongos-Figuero
- Department of Internal Medicine, Hospital Universitario Rio Hortega, Calle Dulzaina, 2, 47012, Valladolid, Spain
| | - Jose L Perez-Castrillon
- Department of Internal Medicine, Hospital Universitario Rio Hortega, Calle Dulzaina, 2, 47012, Valladolid, Spain
| | - Josep Redon
- INCLIVA Biomedical Research Institute, Menéndez y Pelayo, 4, 46010, Valencia, Spain
| | - Maria Tellez-Plaza
- Department of Preventive Medicine and Microbiology, School of Medicine, Universidad Autónoma de Madrid, Arzobispo Morcillo, 4, 28029, Madrid, Spain; Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Instituto de Salud Carlos III, Monforte de Lemos, 5, 28029, Madrid, Spain; INCLIVA Biomedical Research Institute, Menéndez y Pelayo, 4, 46010, Valencia, Spain.
| | - Juan C Martin-Escudero
- Department of Internal Medicine, Hospital Universitario Rio Hortega, Calle Dulzaina, 2, 47012, Valladolid, Spain
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Yang P, Li D, Li X, Tan Z, Wang H, Niu X, Han Y, Lian C. High-density lipoprotein cholesterol levels is negatively associated with intertrochanter bone mineral density in adults aged 50 years and older. Front Endocrinol (Lausanne) 2023; 14:1109427. [PMID: 37033266 PMCID: PMC10080100 DOI: 10.3389/fendo.2023.1109427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/10/2023] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND High-density lipoprotein cholesterol (HDL-C) has long been viewed as a protective factor for cardiovascular health. Yet, higher HDL-C was not necessarily beneficial. The purpose of this study was to investigate the relationship between HDL-C levels and intertrochanter bone mineral density. METHODS The study collected the most recent data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES). Weighted multiple regression analysis was used to evaluate the relationship between HDL-C and intertrochanter BMD, and further subgroup analysis and threshold effect analysis were conducted. Finally, the relationship between HDL-C and intertrochanter BMD was analyzed by fitting smooth curves. RESULTS The study included 3,345 people ranging in age from 50 to 80. HDL-C was discovered to be negatively correlated with intertrochanter BMD (β = -0.03, 95%CI: -0.04, -0.01, P = 0.0002). In subgroup analysis, the negative correlation was found among 60-70-year-olds (β = -0.04, 95%CI: -0.06, -0.02, P = 0.0010), additionally, non-Hispanic whites (β = -0.03, 95%CI: -0.05, -0.01, P = 0.0140), and obese individuals (β = -0.03, 95%CI: -0.05, -0.01, P = 0.0146). The negative correlation, on the other hand, remained significant and consistent across genders, menstruation status, hormone usage, and long-term use of steroids. The relationship between HDL-C and intertrochanter BMD was an inverted U-shaped curve in men and hormone users, with inflection points of 1.01 mmol/L and 1.71 mmol/L, and an U-shaped curve in other Hispanic and premenopausal individuals, with inflection points of 0.96 mmol/L and 1.89 mmol/L. CONCLUSIONS HDL-C was negatively associated with intertrochanter BMD in people over 50 years of age, non-Hispanic whites, and obesity.
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Affiliation(s)
- Pei Yang
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
| | - DongDong Li
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi, China
| | - Xiaokang Li
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi, China
| | - Zongbiao Tan
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Huan Wang
- Department of Orthopaedic, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi, China
| | - Xiaona Niu
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi, China
- *Correspondence: Cheng Lian, ; Yang Han, ; Xiaona Niu,
| | - Yang Han
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
| | - Cheng Lian
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
- *Correspondence: Cheng Lian, ; Yang Han, ; Xiaona Niu,
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Xie R, Huang X, Liu Q, Liu M. Positive association between high-density lipoprotein cholesterol and bone mineral density in U.S. adults: the NHANES 2011-2018. J Orthop Surg Res 2022; 17:92. [PMID: 35168655 PMCID: PMC8848786 DOI: 10.1186/s13018-022-02986-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/03/2022] [Indexed: 12/31/2022] Open
Abstract
Background Serum lipids are highly inheritable and play a major role in bone health. However, the relationship between high-density lipoprotein cholesterol (HDL-C) and bone mineral density (BMD) remains uncertain. The goal of this study was to see if there was a link between HDL-C levels and BMD in persons aged 20–59. Methods Multivariate logistic regression models were used to determine the link between HDL-C and lumbar BMD using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2018. Generalized additive models and fitted smoothing curves were also used. Results The analysis included a total of 10,635 adults. After controlling for various variables, we discovered that HDL-C was positively linked with lumbar BMD. The favorable connection of HDL-C with lumbar BMD was maintained in subgroup analyses stratified by sex and race in women, but not in men, and in blacks, but not in whites. The relationship between HDL-C and lumbar BMD in men and whites was a U-shaped curve with the same inflection point: 0.98 mmol/L. Conclusions In people aged 20 to 59, our research discovered a positive relationship among HDL-C and lumbar BMD. Among males and whites, this relationship followed a U-shaped curve (inflection point: 0.98 mmol/L). HDL-C measurement might be used as a responsive biomarker for detecting osteoporosis early and guiding therapy.
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Affiliation(s)
- Ruijie Xie
- Department of Hand Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, 421002, China
| | - Xiongjie Huang
- Department of Hand Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, 421002, China
| | - Qianlong Liu
- Department of Hand Surgery, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, 410004, China
| | - Mingjiang Liu
- Department of Hand Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, 421002, China.
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Wung CH, Chung CY, Wu PY, Huang JC, Tsai YC, Chen SC, Chiu YW, Chang JM. Associations between Metabolic Syndrome and Obesity-Related Indices and Bone Mineral Density T-Score in Hemodialysis Patients. J Pers Med 2021; 11:jpm11080775. [PMID: 34442419 PMCID: PMC8402197 DOI: 10.3390/jpm11080775] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/03/2021] [Accepted: 08/08/2021] [Indexed: 12/15/2022] Open
Abstract
Previous studies have reported inconsistent results regarding the associations between metabolic syndrome (MetS) and obesity-related indices and bone mineral density (BMD). However, no previous studies have reported these associations among hemodialysis (HD) patients. The aims of this study were to investigate associations between MetS and its components and BMD T-score in HD patients and also between obesity-related indices and BMD T-score in HD patients with and without MetS. MetS was defined according to the Adult Treatment Panel III for Asians, and BMD T-score was calculated using dual-energy X-ray absorptiometry. Eight obesity-related indices were evaluated, including lipid accumulation product (LAP), visceral adiposity index (VAI), body adiposity index, conicity index (CI), body roundness index (BRI), abdominal volume index (AVI), waist-to-height ratio (WHtR), waist–hip ratio, and body mass index (BMI). One hundred and sixty-four patients undergoing HD were enrolled, and the prevalence of MetS was 61.6%. MetS was significantly associated with high lumbar spine and total hip T-scores. Regarding the MetS components, abdominal obesity and low HDL-C were significantly associated with high lumbar spine, femoral neck, and total hip T-scores; hypertriglyceridemia was significantly associated with high lumbar spine and total hip T-scores; hyperglycemia was significantly associated with a high lumbar spine T-score, whereas high blood pressure was not associated with T-score at any site. In the patients with MetS, BMI, WHtR, AVI, and BRI were significantly associated with T-score at all sites, and high CI, VAI, and LAP were also related to a high lumbar T-score. However, these indices were not associated with T-score at any site in patients without MetS. This study demonstrated positive associations between MetS and its five components and BMD T-score among HD patients. MetS, abdominal obesity, hypertriglyceridemia, and low HDL-cholesterol were associated with low risk of osteoporosis among the HD patients. Furthermore, we found that some obesity-related indices were associated with BMD T-score among HD patients with MetS but not in those without MetS. Our study highlights the importance of BMI, WHtR, AVI, and BRI in predicting the risk of osteoporosis among HD patients with MetS. In clinical practice, they can be easily calculated through simple anthropometric measurements and routine laboratory examinations and be used to quickly and conveniently assess the risk of osteoporosis among HD patients.
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Affiliation(s)
- Chih-Hsuan Wung
- Department of Post Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Cheng-Yin Chung
- Division of Nephrology, Department of Internal Medicine, Ministry of Health and Welfare, Pingtung Hospital, Pingtung 900, Taiwan;
| | - Pei-Yu Wu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-Y.W.); (J.-C.H.); (Y.-C.T.); (Y.-W.C.); (J.-M.C.)
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
| | - Jiun-Chi Huang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-Y.W.); (J.-C.H.); (Y.-C.T.); (Y.-W.C.); (J.-M.C.)
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Yi-Chun Tsai
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-Y.W.); (J.-C.H.); (Y.-C.T.); (Y.-W.C.); (J.-M.C.)
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Szu-Chia Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-Y.W.); (J.-C.H.); (Y.-C.T.); (Y.-W.C.); (J.-M.C.)
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-8036783-3440; Fax: +886-7-8063346
| | - Yi-Wen Chiu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-Y.W.); (J.-C.H.); (Y.-C.T.); (Y.-W.C.); (J.-M.C.)
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Jer-Ming Chang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-Y.W.); (J.-C.H.); (Y.-C.T.); (Y.-W.C.); (J.-M.C.)
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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