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Hou X, Tian F, Guo L, Yu Y, Hu Y, Chen S, Wang M, Yang Z, Wang J, Fan X, Xing L, Wu S, Zhang N. Remnant cholesterol is associated with hip BMD and low bone mass in young and middle-aged men: a cross-sectional study. J Endocrinol Invest 2024; 47:1657-1665. [PMID: 38183565 DOI: 10.1007/s40618-023-02279-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 12/08/2023] [Indexed: 01/08/2024]
Abstract
PURPOSE Remnant cholesterol (RC) is a contributor to cardiovascular diseases, obesity, diabetes, and metabolic syndrome. However, the specific relationship between RC and bone metabolism remains unexplored. Therefore, we aimed to investigate the relationships of RC with hip bone mineral density (BMD) and the risk of low bone mass. METHODS Physical examination data was collected from men aged < 60 years as part of the Kailuan Study between 2014 and 2018. The characteristics of the participants were compared between RC quartile groups. A generalized linear regression model was used to evaluate the relationship between RC and hip BMD and a logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for low bone mass. Additional analyses were performed after stratification by body mass index (BMI) (≥ or < 24 kg/m2). Sensitivity analyses were performed by excluding individuals who were taking lipid-lowering therapy or had cancer, cardiovascular diseases, or diabetes. RESULTS Data from a total of 7,053 participants were included in the analysis. After adjustment for confounding factors, RC negatively correlated with hip BMD (β = - 0.0079, 95% CI: - 0.0133, - 0.0025). The risk of low bone mass increased from the lowest to the highest RC quartile, with ORs of 1 (reference), 1.09 (95% CI: (0.82, 1.44), 1.35 (95%CI: 1.02, 1.77), and 1.43 (95% CI: 1.09, 1.89) for Q1, Q2, Q3, and Q4, respectively (P for trend = 0.004) in the fully adjusted model. Compared to RC < 0.80 mmol/l group, the risk of low bone mass increased 39% in RC ≥ 0.80 mmol/l group (P < 0.001). The correlation between RC and hip BMD was stronger in participants with BMI ≥ 24 kg/m2 group (β = - 0.0159, 95% CI: - 0.0289, - 0.0029). The results of sensitivity analyses were consistent with the main results. CONCLUSION We have identified a negative correlation between serum RC and hip BMD, and a higher RC concentration was found to be associated with a greater risk of low bone mass in young and middle-aged men.
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Affiliation(s)
- X Hou
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - F Tian
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - L Guo
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Y Yu
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Y Hu
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - S Chen
- Kailuan General Hospital, Tangshan, People's Republic of China
| | - M Wang
- Beijing Jishuitan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Z Yang
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - J Wang
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - X Fan
- Kailuan General Hospital, Tangshan, People's Republic of China
| | - L Xing
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
- Affiliated Hospital of North China University of Science and Technology, Tangshan, People's Republic of China
| | - S Wu
- Kailuan General Hospital, Tangshan, People's Republic of China.
| | - N Zhang
- Kailuan General Hospital, Tangshan, People's Republic of China.
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Wang J, Li S, Pu H, He J. The association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and the risk of osteoporosis among U.S. adults: analysis of NHANES data. Lipids Health Dis 2024; 23:161. [PMID: 38831342 PMCID: PMC11145830 DOI: 10.1186/s12944-024-02152-7] [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: 03/16/2024] [Accepted: 05/17/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Osteoporosis and atherosclerosis frequently afflict older adults, and recent insights suggest a deeper connection between these conditions that surpasses mere aging effects. The ratio of non-high-density to high-density lipoprotein cholesterol (NHHR) has emerged as a novel lipid marker for evaluating the risk of cardiovascular diseases. Nonetheless, investigations into the correlation of the NHHR with the risk of developing osteoporosis remain unexplored. METHODS We collected NHHR and bone mineral density (BMD) data from 11,024 National Health and Nutrition Examination Survey (NHANES) participants between 2011 and 2018. Multivariate linear regression was employed to examine the correlation between BMD and NHHR. Smooth curves were employed to deal with the nonlinearity. To further account for the nonlinear link, we used a two-part linear regression model. The threshold effects were estimated using two components of a linear regression model. Subgroup and sensitivity analyses were carried out to ascertain the stability of the findings. RESULTS We discovered a negative relationship between the NHHR and lumbar spine BMD in all three models. An L-shaped curvilinear association existed between the NHHR and lumbar spine BMD, with a key inflection point of 6.91. The fully adjusted model showed that the BMD of the lumbar spine fell by 0.03 g/cm2 in those who were in the fourth quartile as opposed to the lowest quartile. The sensitivity analysis using unweighted logistic analysis verified the stability of the results. In addition, BMD in the nondiabetic group was more significantly affected by the negative effect of the NHHR in the subgroup analysis. CONCLUSIONS According to this research, there appears to be a negative correlation between BMD and NHHR in US Adults. To clarify the precise physiological mechanisms by which the NHHR contributes to the onset of osteoporosis, more research is necessary.
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Affiliation(s)
- Jinzhou Wang
- The Department of Orthopaedic Surgery, the Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, 637000, China
| | - Shanshan Li
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400000, China
| | - Hongyu Pu
- The Department of Orthopaedic Surgery, Fushun People's Hospital, Zigong, Sichuan Province, 643000, China
| | - Jiangtao He
- The Department of Orthopaedic Surgery, the Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, 637000, China.
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Cui G, Xu N, Zhao S, Chen R, Liu Q, Liu X, Kuang M, Han S. TC and LDL-C are negatively correlated with bone mineral density in patients with osteoporosis. Am J Transl Res 2024; 16:163-178. [PMID: 38322569 PMCID: PMC10839398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 12/10/2023] [Indexed: 02/08/2024]
Abstract
OBJECTIVE To investigate the relationships of multiple lipid metabolism indicators and bone turnover markers (BTMs) with bone mineral density (BMD) and osteoporosis, in order to identify high-risk populations. METHODS A total of 380 patients were recruited and their general information was collected. Linear and logistic regression models were used to analyze the correlation of these indicators with BMD and osteoporosis. RESULTS Lipid metabolism indices and BTMs exhibited varying degrees of positive or negative correlation with BMD. Elevated levels of triglycerides (r = -0.204, P = 0.004), total cholesterol (TC) (r = -0.244, P < 0.001), low-density lipoprotein cholesterol (LDL-C) (r = -0.256, P < 0.001), apoprotein B (r = -0.292, P < 0.001) and lipoprotein-associated phospholipase A2 (Lp-PLA2) (r = -0.221, P = 0.002) in women were associated with a reduction in BMD. This relationship persisted even after adjusting for confounding factors and in the subgroup analysis of elderly women. In males, TC (r = 0.159, P = 0.033), LDL-C (r = 0.187, P = 0.012), apoprotein B (r = 0.157, P = 0.035), and Lp-PLA2 (r = 0.168, P = 0.024) exhibited a positive correlation with BMD, while free fatty acid (FFA) (r = -0.153, P = 0.041) was negatively correlated with BMD. However, after adjusting for confounding factors, only FFA remained negatively correlated with BMD, which was not observed in the age subgroup analysis. Furthermore, elevated levels of TC and LDL-C in elderly women were positively associated with the risk of osteoporosis or low bone mass. CONCLUSION Elevated levels of TC and LDL-C not only indicate a decrease in BMD in females but also positively correlate with the occurrence of osteoporosis and low bone mass in elderly females.
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Affiliation(s)
- Guanzheng Cui
- Department of Spinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan, Shandong, China
| | - Ning Xu
- Department of Spinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan, Shandong, China
| | - Shengyin Zhao
- Department of Spinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan, Shandong, China
| | - Rudong Chen
- Department of Spinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan, Shandong, China
| | - Qian Liu
- Department of Pain, Qilu Hospital, Shandong UniversityJinan, Shandong, China
| | - Xuchang Liu
- Department of Spinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan, Shandong, China
| | - Mingjie Kuang
- Department of Spinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan, Shandong, China
- Key Laboratory of Biopharmaceuticals, Postdoctoral Scientific Research Workstation, Shandong Academy of Pharmaceutical ScienceJinan, Shandong, China
| | - Shijie Han
- Department of Spinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan, Shandong, 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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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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Zhao Z, Fan W, Wang L, Chu Q. The Paradoxical Association of Lipids with Survival and Walking Ability of Hip Fractures in Geriatric Patients After Surgery: A 1-Year Follow-Up Study. Int J Gen Med 2023; 16:3907-3919. [PMID: 37662501 PMCID: PMC10473408 DOI: 10.2147/ijgm.s417499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/07/2023] [Indexed: 09/05/2023] Open
Abstract
Background We aimed to explore the association between lipids and the survival and walking ability of hip fractures in geriatric patients after surgery. Methods Restricted cubic spline (RCS) was established to explore the nonlinear relationship between lipids and 1-year mortality of hip fractures, and the cut-off points were also determined by RCS. Then, the patients were divided into three groups: low, middle, and high levels of LDL-c. Then, the survival and walking ability of patients from different groups were compared, and the Cox regression and Logistics regression were used to identify the relationships between lipids and the survival and walking ability of hip fractures. Results The patients with middle levels of LDL-c had a significantly high survival probability than those with low or high levels of LDL-c (p < 0.001). The patients with low levels of LDL-c and with high levels of LDL-c may have a poor prognosis compared with patients with middle levels of LDL-c in 6-month mortality, 6-month free walking ability, 1-year mortality, and 1-year free walking ability (All p < 0.05). Conclusion Low and high levels of LDL-c may both relate to the poor survival and walking ability of hip fractures.
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Affiliation(s)
- Zhibang Zhao
- Emergency Trauma Center, Nanyang Second People’s Hospital, Nanyang, Henan, People’s Republic of China
| | - Wenliang Fan
- Emergency Trauma Center, Nanyang Second People’s Hospital, Nanyang, Henan, People’s Republic of China
| | - Liqiang Wang
- Emergency Trauma Center, Nanyang Second People’s Hospital, Nanyang, Henan, People’s Republic of China
| | - Qingbo Chu
- Emergency Trauma Center, Nanyang Second People’s Hospital, Nanyang, Henan, People’s Republic of China
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Lv F, Cai X, Lin C, Yang W, Hu S, Ji L. Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors and the Risk of Fracture: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Calcif Tissue Int 2023:10.1007/s00223-023-01085-0. [PMID: 37099141 DOI: 10.1007/s00223-023-01085-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/13/2023] [Indexed: 04/27/2023]
Abstract
Osteoporosis and hyperlipidemia are closely correlated and statins might be associated with a decreased risk of fracture. We aimed to investigate the association between proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) therapy and the risk of fracture. The PubMed, Cochrane library, and EMBASE databases were systematically searched from the inception dates to October 22, 2022. Randomized clinical trials (RCTs) that addressed to fracture events of participants using alirocumab, evolocumab, bococizumab or inclisiran, with a follow-up of ≥ 24 weeks were included. Meta-analyses were conducted to calculate the odds ratio (OR) with 95% confidence intervals (CIs) for major osteoporotic fracture, hip fracture, osteoporotic non-vertebral fracture, and total fracture. 30 trials assessing PCSK9i among 95, 911 adults were included. There were no significant associations between PCSK9i therapy and the risk of major osteoporotic fracture [OR 1.08 (95% Cl 0.87-1.34), p = 0.49], hip fracture [OR 1.05 (95% Cl 0.73-1.53), p = 0.79], osteoporotic non-vertebral fracture [OR 1.03 (95% Cl 0.80-1.32), p = 0.83], and total fracture [OR 1.03 (95% Cl 0.88-1.19), p = 0.74] over a period of 6-64 months. No significant associations were detected in any of the sensitivity analyses and subgroup analyses stratified by the type of PCSK9i, follow-up duration, age, sex, sample size, and patient profile. Pooled results of our meta-analysis showed that exposure to PCSK9i was not associated with reduced risks of fracture in the short term.
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Affiliation(s)
- Fang Lv
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Xiaoling Cai
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
| | - Chu Lin
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Wenjia Yang
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Suiyuan Hu
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
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Zhao X, Sun J, Xin S, Zhang X. Correlation between Blood Lipid Level and Osteoporosis in Older Adults with Type 2 Diabetes Mellitus—A Retrospective Study Based on Inpatients in Beijing, China. Biomolecules 2023; 13:biom13040616. [PMID: 37189364 DOI: 10.3390/biom13040616] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/12/2023] [Accepted: 03/23/2023] [Indexed: 04/01/2023] Open
Abstract
Objective: to analyze the association between blood lipid metabolism and osteoporosis (OP) in older adults with type 2 diabetes mellitus (T2DM). Methods: a total of 1158 older patients with T2DM treated by the Department of Endocrinology, Peking University International Hospital, were retrospectively analyzed, including 541 postmenopausal women and 617 men. Results: (1) Levels of low-density lipoprotein cholesterol (LDL-C) were significantly higher in the OP group, while levels of high-density lipoprotein cholesterol (HDL-C) were higher in the non-osteoporotic group (both p < 0.05). (2) Age, parathyroid hormone (PTH), total cholesterol (TC) and LDL-C were negatively linked to the patients’ bone mineral density (BMD) (all p < 0.05), while the body mass index (BMI), uric acid (UA) level, HDL-C level and glomerular filtration rate (eGFR) were positively related to their BMD (all p < 0.05). (3) In postmenopausal women, after adjustment for other indexes, raised LDL-C is an independent risk factor for OP (OR = 3.38, 95% CI 1.64, 6.98, p < 0.05) while raised HDL-C is protective (OR = 0.49, 95% CI 0.24, 0.96, p < 0.05). However, raised HDL-C was protective against OP (OR = 0.07, 95% CI 0.01, 0.53, p < 0.05). Conclusion: In older T2DM patients, the effect of blood lipid levels is related to sex. Our study conducted a detailed sex stratification. In addition to seeing the traditional risk factors of OP, such as age, sex, and BMI, we comprehensively analyzed the correlation between the blood glucose level, complications, and blood lipids with OP. HDL-C is a protective factor for OP in both men and women, while LDL-C independently predicts OP in postmenopausal women.
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