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Zhang Z, Duan Y, Huo J. Lipid Metabolism, Methylation Aberrant, and Osteoporosis: A Multi-omics Study Based on Mendelian Randomization. Calcif Tissue Int 2024; 114:147-156. [PMID: 38071623 DOI: 10.1007/s00223-023-01160-6] [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: 08/10/2023] [Accepted: 11/03/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Observational studies have shown a causal association between dyslipidemia and osteoporosis, but the genetic causation and complete mechanism of which are uncertain. The disadvantage of previous observational studies is that they are susceptible to confounding factors and bias, that makes it difficult to infer a causal link between those two diseases. Abnormal epigenetic modifications, represented by DNA methylation, are important causes of many diseases. However, there are no studies showing a bridging role for methylation modifications in blood lipid metabolism and osteoporosis. METHODS SNPs for lipid profile (Blood VLDL cholesterol (VLDL-C), blood LDL cholesterol (LDL-C), blood HDL cholesterol (HDL-C), blood triglycerides (TG), diagnosed pure hypercholesterolaemia, blood apolipoprotein B (Apo B), blood apolipoprotein A1(Apo A1)), and bone mineral density (BMD) in different body parts (Heel BMD, lumbar BMD, whole-body BMD, femoral neck BMD) were obtained from large meta-analyses of genome-wide association studies as instrumental variables for two-sample Mendelian randomization. Assessment of the genetic effects of lipid profile-associated methylation sites and bone mineral density was carried out using the summary-data-based Mendelian randomization (SMR) method. RESULTS Two-sample Mendelian randomization showed that there was a negative causal association between hypercholesterolaemia and heel BMD (p = 0.0103, OR = 0.4590), and total body BMD (p = 0.0002, OR = 0.2826). LDL-C had a negative causal association with heel BMD (p = 8.68E-05, OR = 0.9586). VLDL-C had a negative causal association with heel BMD (p = 0.035, OR = 0.9484), lumbar BMD (p = 0.0316, OR = 0.9356), and total body BMD (p = 0.0035, OR = 0.9484). HDL-C had a negative causal association with heel BMD (p = 1.25E-05, OR = 0.9548), lumbar BMD (p = 0.0129, OR = 0.9358), and total body BMD (p = 0.0399, OR = 0.9644). Apo B had a negative causal association with heel BMD (p = 0.0001, OR = 0.9647). Apo A1 had a negative causal association with heel BMD (p = 0.0132, OR = 0.9746) and lumbar BMD (p = 0.0058, OR = 0.9261). The p-values of all positive results corrected by the FDR method remained significant and sensitivity analysis showed that there was no horizontal pleiotropy in the results despite the heterogeneity in some results. SMR identified 3 methylation sites associated with lipid profiles in the presence of genetic effects on BMD: cg15707428(GREB1), cg16000331(SREBF2), cg14364472(NOTCH1). CONCLUSION Our study provides insights into the potential causal links and co-pathogenesis between dyslipidemia and osteoporosis. The genetic effects of dyslipidaemia on osteoporosis may be related to certain aberrant methylation genetic modifications.
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Affiliation(s)
- ZhaoLiang Zhang
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China
| | - YuChen Duan
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China
| | - JianZhong Huo
- Taiyuan Central Hospital, Ninth Hospital of Shanxi Medical University, Southern Fendong Road 256, Taiyuan, 030009, Shanxi, 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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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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Akhmetshina A, Kratky D, Rendina-Ruedy E. Influence of Cholesterol on the Regulation of Osteoblast Function. Metabolites 2023; 13:metabo13040578. [PMID: 37110236 PMCID: PMC10143138 DOI: 10.3390/metabo13040578] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/11/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
Bone is a dynamic tissue composed of cells, an extracellular matrix, and mineralized portion. Osteoblasts are responsible for proper bone formation and remodeling, and function. These processes are endergonic and require cellular energy in the form of adenosine triphosphate (ATP), which is derived from various sources such as glucose, fatty acids, and amino acids. However, other lipids such as cholesterol have also been found to play a critical role in bone homeostasis and can also contribute to the overall bioenergetic capacity of osteoblasts. In addition, several epidemiological studies have found a link between elevated cholesterol, cardiovascular disease, an enhanced risk of osteoporosis, and increased bone metastasis in cancer patients. This review focuses on how cholesterol, its derivatives, and cholesterol-lowering medications (statins) regulate osteoblast function and bone formation. It also highlights the molecular mechanisms underlying the cholesterol-osteoblast crosstalk.
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Affiliation(s)
- Alena Akhmetshina
- Gottfried Schatz Research Center, Molecular Biology and Biochemistry, Medical University of Graz, 8010 Graz, Austria
- Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Dagmar Kratky
- Gottfried Schatz Research Center, Molecular Biology and Biochemistry, Medical University of Graz, 8010 Graz, Austria
- BioTechMed-Graz, 8010 Graz, Austria
| | - Elizabeth Rendina-Ruedy
- Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37235, USA
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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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Fang W, Peng P, Xiao F, He W, Wei Q, He M. A negative association between total cholesterol and bone mineral density in US adult women. Front Nutr 2022; 9:937352. [PMID: 36245496 PMCID: PMC9562045 DOI: 10.3389/fnut.2022.937352] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/15/2022] [Indexed: 11/28/2022] Open
Abstract
Background The association between serum total cholesterol (TC) and bone mineral density (BMD) is still controversial. We aimed to evaluate the association of serum TC with BMD in general US adult women. Methods A cross-sectional study consisting of 7,092 (age range 20–85) participants from the National Health and Nutrition Examination Survey (NHANES) database was conducted. Weighted multivariate linear regression analyses were performed to evaluate association between serum TC and lumbar spine BMD. In addition, subgroup and interaction analysis were used in this study. Results The serum TC was negatively correlated with lumbar spine BMD after adjusting for confounders. Subgroup analysis found that the strongest negative association mainly exists in women aged over 45 years with body mass index (BMI) < 24.9 kg/m2, and this association is not significant in other groups. Conclusions This study found that serum TC exhibit an inverse association with lumbar spine BMD in Us women aged over 45 years. The measurement of serum TC may provide information for predicting poor bone health outcomes in these women.
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Affiliation(s)
- Weihua Fang
- The Third Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peng Peng
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fangjun Xiao
- The Third Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei He
- Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, Guangzhou, China
- Department of Orthopaedics, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiushi Wei
- Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, Guangzhou, China
- Department of Orthopaedics, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Qiushi Wei
| | - Mincong He
- Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, Guangzhou, China
- Department of Orthopaedics, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
- Mincong He
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8
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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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Anagnostis P, Florentin M, Livadas S, Lambrinoudaki I, Goulis DG. Bone Health in Patients with Dyslipidemias: An Underestimated Aspect. Int J Mol Sci 2022; 23:ijms23031639. [PMID: 35163560 PMCID: PMC8835770 DOI: 10.3390/ijms23031639] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 02/04/2023] Open
Abstract
Beyond being aging-related diseases, atherosclerosis and osteoporosis share common pathogenetic pathways implicated in bone and vascular mineralization. However, the contributory role of dyslipidemia in this interplay is less documented. The purpose of this narrative review is to provide epidemiological evidence regarding the prevalence of bone disease (osteoporosis, fracture risk) in patients with dyslipidemias and to discuss potential common pathophysiological mechanisms linking osteoporosis and atherosclerosis. The effect of hypolipidemic therapy on bone metabolism is also discussed. Despite the high data heterogeneity and the variable quality of studies, dyslipidemia, mainly elevated total and low-density lipoprotein cholesterol concentrations, is associated with low bone mass and increased fracture risk. This effect may be mediated directly by the increased oxidative stress and systemic inflammation associated with dyslipidemia, leading to increased osteoclastic activity and reduced bone formation. Moreover, factors such as estrogen, vitamin D and K deficiency, and increased concentrations of parathyroid hormone, homocysteine and lipid oxidation products, can also contribute. Regarding the effect of hypolipidemic medications on bone metabolism, statins may slightly increase BMD and reduce fracture risk, although the evidence is not robust, as it is for omega-3 fatty acids. No evidence exists for the effects of ezetimibe, fibrates, and niacin. In any case, more prospective studies are needed further to elucidate the association between lipids and bone strength.
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Affiliation(s)
- Panagiotis Anagnostis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece;
- Correspondence: ; Tel.: +30-2310-257150; Fax: +30-2310-281179
| | - Matilda Florentin
- Department of Internal Medicine, University Hospital of Ioannina, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece;
| | | | - Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece;
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10
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Zolfaroli I, Ortiz E, García-Pérez MÁ, Hidalgo-Mora JJ, Tarín JJ, Cano A. Positive association of high-density lipoprotein cholesterol with lumbar and femoral neck bone mineral density in postmenopausal women. Maturitas 2021; 147:41-46. [PMID: 33832646 DOI: 10.1016/j.maturitas.2021.03.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/08/2021] [Accepted: 03/02/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Experimental studies suggest that lipids affect bone metabolism. We aimed to elucidate whether lipid levels are associated with bone mineral density (BMD) in a cohort of postmenopausal women. DESIGN A cross-sectional study of participants in the Chronic Ailment Reduction after MENopause (CARMEN) cohort. Women underwent assessment of clinical and analytical parameters, including fasting lipid levels. BMD was assessed at both lumbar spine and hip. Homogeneity in the cohort was optimized by filtering out a series of confounding variables with a known impact on bone. MAIN OUTCOME MEASURES Association of BMD at lumbar spine and femoral neck with lipid levels. RESULTS A total of 667 of the 1304 screened women were analyzed. A strong correlation was revealed between total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in univariate analysis. Multivariate analysis detected a significant positive association of HDL-C with BMD at both spine (p = 0.007) and femoral neck (p = 0.013). Other independent predictors of spine BMD were years since menopause (ysm, negatively associated), and body mass index (BMI) and estradiol, both positively associated with BMD. The other independent variables in the femoral neck were ysm and glucose (negatively associated) and BMI, estradiol, and phosphate, all positively associated with BMD. CONCLUSION Levels of HDL-C, but not TC, LDL-C or triglycerides, were positively associated with BMD at both the lumbar spine and femoral neck in a homogeneous cohort of postmenopausal women.
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Affiliation(s)
- Irene Zolfaroli
- Service of Obstetrics and Gynecology, Hospital Clínico-INCLIVA, Av Blasco Ibáñez 17, 46010, Valencia, Spain.
| | - Ester Ortiz
- Service of Obstetrics and Gynecology, Hospital Universitario Dr Peset, Av Gaspar Aguilar 90, 46017, Valencia, Spain.
| | - Miguel-Ángel García-Pérez
- Department of Genetics, Faculty of Biological Sciences, University of Valencia, Burjassot, and INCLIVA, Burjassot, 46100, Valencia, Spain.
| | - Juan José Hidalgo-Mora
- Service of Obstetrics and Gynecology, Hospital Clínico-INCLIVA, Av Blasco Ibáñez 17, 46010, Valencia, Spain.
| | - Juan J Tarín
- Department of Cellular Biology, Functional Biology and Physical Anthropology, Faculty of Biological Sciences, University of Valencia, Burjassot, 46100, Valencia, Spain.
| | - Antonio Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia and INCLIVA, Av Blasco Ibáñez 15, 46010, Valencia, Spain.
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11
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Värri M, Niskanen L, Tuomainen TP, Honkanen R, Kröger H, Tuppurainen MT. Metabolite Profiling of Osteoporosis and Atherosclerosis in Postmenopausal Women: A Cross-Sectional Study. Vasc Health Risk Manag 2020; 16:515-524. [PMID: 33293818 PMCID: PMC7719314 DOI: 10.2147/vhrm.s279028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/19/2020] [Indexed: 02/02/2023] Open
Abstract
Purpose Atherosclerosis (AS) and osteoporosis (OP) are common causes of morbidity and mortality in postmenopausal women and are connected via an unknown mechanistic link. Metabolite profiling of blood samples may allow the identification of new biomarkers and pathways for this enigmatic association. Patients and Methods We studied the difference in 148 metabolite levels from serum samples in postmenopausal women with AS and OP compared with those in healthy participants in this cross-sectional study. Quantitative AS was assessed by carotid artery intima-media thickness (cIMT) and carotid artery calcifications (CACs) by ultrasound, as well as OP by femoral neck (FN) bone mineral density (BMD) and 148 metabolic measures with high-throughput proton (1H) nuclear magnetic resonance (NMR) in serum samples from 280 postmenopausal (PM) women. Subjects were a randomly selected subsample from the population-based Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study. The final study population included the following groups: OP with CAC (n=16, group I), non-OP with no CAC (n=59, group II), high cIMT tertile with OP (n=11, group III) and low cIMT tertile without OP (n=48, group IV). Results There were differences in several metabolite levels between groups I and II. The acetate level was lower in group I compared to that in group II (group I mean ± SD: 0.033 ± 0.0070; group II: 0.041 ± 0.014, CI95%: 0.018‒0.15, p=0.014). The result was similar with diacylglycerol (p=0.002), leucine (p=0.031), valine (p=0.022) and several very low-density lipoprotein (VLDL) metabolite levels, which were lower in group I compared to those in group II. However, no associations were found in adjusted analyses with total body (TB) fat mass (FM), age and statin use (p>0.05). Conclusion Our novel study found differences in the metabolite profiling of altered amino acid and lipoprotein metabolism in participants with OP and AS compared with those in healthy women. The causative mechanisms remain unknown and further studies are needed.
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Affiliation(s)
- Miika Värri
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Leo Niskanen
- Department of Endocrinology and Metabolism, Abdominal Centre, Helsinki University Hospital, Universities of Helsinki and Eastern Finland, Helsinki, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Risto Honkanen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Lapland Hospital District, Rovaniemi, Finland
| | - Heikki Kröger
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Marjo T Tuppurainen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Obstetrics and Gynaecology, Kuopio University Hospital, Kuopio, Finland
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12
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Zhao H, Zheng C, Gan K, Qi C, Ren L, Song G. High Body Mass Index and Triglycerides Help Protect against Osteoporosis in Patients with Type 2 Diabetes Mellitus. J Diabetes Res 2020; 2020:1517879. [PMID: 33178837 PMCID: PMC7609142 DOI: 10.1155/2020/1517879] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 09/10/2020] [Accepted: 09/25/2020] [Indexed: 01/05/2023] Open
Abstract
PURPOSE This study was conducted to investigate whether high body mass index (BMI) and triglycerides (TGs) were protective factors for reducing osteoporosis (OP) in patients with type 2 diabetes mellitus (T2DM). Participants and Methods. Seventy-nine patients (aged 20 to 81) with T2DM were included in the study. Basic information and blood indicators were collected. Bone mineral density was used to diagnose OP. Participants were grouped according to BMI (normal weight vs. overweight/obese participants), TG (normal TG vs. hypertriglyceridemia), and OP (non-OP vs. OP), and differences were compared between groups. Regression analysis was used to explore whether BMI or TG were independent factors affecting OP. RESULTS The proportions of OP in the overweight/obese and hypertriglyceridemic groups were significantly lower than those in the normal weight (30.0% vs. 69.0%; P = 0.001) and normal TG (27.3% vs. 56.5%; P = 0.010) groups. In the OP group, the BMI (24.8 ± 3.4 vs. 26.6 ± 2.5 kg/m2; P = 0.009) was significantly lower than that in the non-OP group, and TG showed the same trend (1.30 (0.81) vs. 1.71 (1.1) mmol/L; P = 0.020). Logistic regression in the crude model showed that the odds ratios (ORs) of OP in the overweight/obese and hypertriglyceridemic groups were 0.193 (95% CI: 0.071, 0.520) and 0.315 (95% CI: 0.119, 0.830) compared with those of the normal weight and normal TG groups. After adjusting for sex and smoking, the ORs were 0.204 (95% CI: 0.074, 0.567) and 0.242 (95% CI: 0.082, 0.709) for the overweight/obese and hypertriglyceridemic groups, respectively. After adjusting for all confounding factors, the ORs for these groups were 0.248 (95% CI: 0.083, 0.746) and 0.299 (95% CI: 0.091, 0.989), respectively. CONCLUSION BMI and TG are independent protective factors against OP in patients with T2DM.
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Affiliation(s)
- Hang Zhao
- Endocrinology Department, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei 050051, China
| | - Chong Zheng
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, Hebei 050011, China
| | - Kexin Gan
- Endocrinology Department, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei 050051, China
| | - Cuijuan Qi
- Endocrinology Department, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei 050051, China
| | - Luping Ren
- Endocrinology Department, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei 050051, China
| | - Guangyao Song
- Endocrinology Department, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei 050051, China
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Ghorabi S, Shab-Bidar S, Sadeghi O, Nasiri M, Khatibi SR, Djafarian K. Lipid Profile and Risk of Bone Fracture: A Systematic Review and Meta-Analysis of Observational Studies. Endocr Res 2019; 44:168-184. [PMID: 31165667 DOI: 10.1080/07435800.2019.1625057] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Purpose: Earlier studies have linked lipid profile to osteoporotic fractures; however, to our knowledge, no study had summarized available data on this relationship. We aimed to summarize the current evidence on the association between lipid profile and bone fractures. Material and Methods: A systematic search of PubMed and Scopus was done to find relevant published studies until March 2018. To combine effect sizes, we applied fixed- or random-effects analysis, where appropriate. Cochran's Q test and I2 were used to assess between-study heterogeneity. Results: Overall, 11 studies (seven prospective, three cross-sectional and one case-control studies) were included in the current systematic review. Out of them, 10 studies with a total sample size of 60,484 individuals, aged 25 years or more, were used in the meta-analysis. The results showed that total cholesterol concentration was positively associated with risk of bone fracture; such that a 50-mg/dl increase in plasma level of TC was associated with 15% greater odds of bone fracture (combined effect size: 1.15, 95% CI: 1.02-1.30, P = .02). Furthermore, we found that individuals with a decreased level of HDL (<40 mg/dl) had a lower risk of bone fracture compared with those with a normal level (≥40 mg/dl) (combined effect size: 0.82, 95% CI: 0.71-0.96, P = .01). No significant association was found between plasma level of TG and LDL with the risk of bone fractures either in prospective or cross-sectional studies. Conclusions: We found that plasma levels of total cholesterol were positively associated with bone fractures. In addition, decreased levels of HDL were associated with an increased risk of osteoporotic fractures. Abbreviations: TG: triglycerides, TC: total cholesterol, HDL: high-density lipoprotein, LDL: low-density lipoprotein, OR: odds ratio, RR: relative risk, HR: hazard ratio, DXA: dual-energy X-ray absorptiometry, ICD: International Classification of Diseases, SD: standard deviation.
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Affiliation(s)
- Sima Ghorabi
- Students' Scientific Research Center, Tehran University of Medical Sciences , Tehran , Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran
| | - Omid Sadeghi
- Students' Scientific Research Center, Tehran University of Medical Sciences , Tehran , Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran
| | - Morteza Nasiri
- Student Research Committee, Shiraz University of Medical Sciences , Shiraz , Iran
- Department of Operating Room Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Seyed Reza Khatibi
- Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences , Torbat Heydariyeh , Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences , Torbat Heydariyeh , Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran
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14
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Panahi N, Soltani A, Ghasem-Zadeh A, Shafiee G, Heshmat R, Razi F, Mehrdad N, Nabipour I, Larijani B, Ostovar A. Associations between the lipid profile and the lumbar spine bone mineral density and trabecular bone score in elderly Iranian individuals participating in the Bushehr Elderly Health Program: a population-based study. Arch Osteoporos 2019; 14:52. [PMID: 31079228 DOI: 10.1007/s11657-019-0602-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 04/24/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED We hypothesized that the lipid profile or dyslipidemia may have an influence on the bone mineral density and bone microstructure in an elderly Iranian population. The results of this study showed some significant associations between the serum lipid levels and the lumbar spine and femoral areal bone mineral densities and the trabecular bone score (TBS). PURPOSE Serum lipid abnormalities are possible risk factors for cardiovascular diseases and osteoporosis. Our aim was to evaluate the associations between the lipid profile and the areal bone mineral density (aBMD) and trabecular bone score in an elderly Iranian population. METHODS The study subjects included 2426 elderly women and men participating in the second stage of the Bushehr Elderly Health program, a population-based prospective cohort study. The aBMDs of the lumbar spine and femoral neck and the lumbar spine texture were measured using dual-energy X-ray absorptiometry and the TBS algorithm, respectively. The associations between the lipid profiles and the aBMDs and TBSs were examined using multivariable linear regression analyses stratified by sex and adjusted for potential confounders. RESULTS In men, we found negative correlations between the lumbar spine aBMD and TBS and the total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels (TC: p < 0.001 and p < 0.006, HDL-C: p = 0.002 and p = 0.004, and LDL-C: p < 0.001 and p < 0.009, respectively). However, only the HDL-C level was negatively associated with the aBMD in women (p = 0.016). A positive and statistically significant correlation was found between the serum triglyceride (TG) level and the aBMD in the women (p < 0.001). The TG level and the TBS were not statistically significantly correlated in either sex, and the TBS was not correlated with any of the lipid values in women. CONCLUSION The results of this study showed some significant but generally weak associations between the lipid profile and the aBMD. The associations that were significant for both the men and the women included positive associations between the TG level and the femoral neck aBMD, as well as the HDL-C level and the femoral neck and lumbar spine aBMDs.
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Affiliation(s)
- Nekoo Panahi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Soltani
- Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ghasem-Zadeh
- Departments of Medicine and Endocrinology, University of Melbourne, Australia, Melbourne, Australia
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Razi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Mehrdad
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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15
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Cherny SS, Freidin MB, Williams FMK, Livshits G. The analysis of causal relationships between blood lipid levels and BMD. PLoS One 2019; 14:e0212464. [PMID: 30794634 PMCID: PMC6386286 DOI: 10.1371/journal.pone.0212464] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/01/2019] [Indexed: 12/11/2022] Open
Abstract
Bone mineral density (BMD) and lipid levels are two of the most extensively studied risk factors for common diseases of aging, such as cardiovascular disease (CVD) and osteoporosis (OP). These two risk factors are also correlated with each other, but little is known about the molecular mechanisms behind this correlation. Recent studies revealed that circulating levels of several metabolites involved in the biosynthesis of androsterone correlate significantly with BMD and have the capacity to affect cholesterol and lipids levels. A main aim of the present study was to investigate the hypothesis that androsterone-related metabolites could provide a link between CVD and OP, as a common cause of lipid levels and BMD. The present study employed data from the NIHR BRC TwinsUK BioResource, comprising 1909 and 1994 monozygotic and dizygotic twin pairs, respectively, to address the causal relationships among BMD and lipids, and their associated metabolites, using reciprocal causation twin modelling, as well as Mendelian randomization (MR) using large publicly-available GWAS datasets on lipids and BMD, in conjunction with TwinsUK metabolite data. While results involving the twin modelling and MR analyses with metabolites were unable to establish a causal link between metabolite levels and either lipids or BMD, MR analyses of BMD and lipids suggest that lipid levels have a causal impact on BMD, which is consistent with findings from clinical trials of lipid-lowering drugs, which have also increased BMD.
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Affiliation(s)
- Stacey S. Cherny
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maxim B. Freidin
- Department of Twin Research and Genetic Epidemiology, School of Life Course Science, King’s College London, London, United Kingdom
| | - Frances M. K. Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Science, King’s College London, London, United Kingdom
| | - Gregory Livshits
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Twin Research and Genetic Epidemiology, School of Life Course Science, King’s College London, London, United Kingdom
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16
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Martín-González C, González-Reimers E, Quintero-Platt G, Cabrera-García P, Romero-Acevedo L, Gómez-Rodríguez MÁ, Rodríguez Gaspar M, Martínez-Martínez D, Santolaria-Fernández F. Lipid profile and bone mineral density in heavy alcoholics. Clin Nutr 2018; 37:2137-2143. [DOI: 10.1016/j.clnu.2017.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/05/2017] [Accepted: 10/06/2017] [Indexed: 02/07/2023]
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17
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Yang Y, Liu G, Zhang Y, Xu G, Yi X, Liang J, Zhao C, Liang J, Ma C, Ye Y, Yu M, Qu X. Association Between Bone Mineral Density, Bone Turnover Markers, and Serum Cholesterol Levels in Type 2 Diabetes. Front Endocrinol (Lausanne) 2018; 9:646. [PMID: 30459714 PMCID: PMC6232230 DOI: 10.3389/fendo.2018.00646] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 10/12/2018] [Indexed: 11/13/2022] Open
Abstract
Purpose: The association between bone mineral density (BMD), bone turnover markers, and serum cholesterol in healthy population has already been proved. However, in patients with type 2 diabetes mellitus (T2D), it has not been adequately analyzed. In this study, we investigated the correlation between BMD, bone turnover markers, and serum cholesterol levels in people with T2D. Methods: We enrolled 1,040 men and 735 women with T2D from Zhongshan Hospital between October 2009 and January 2013. Their general condition, history of diseases and medication, serum markers, and BMD data were collected. We used logistic regression analysis to identify the association between serum cholesterol levels and BMD as well as bone turnover markers. Results: In multivariate regression analysis, we observed that in men with T2D, high high-density lipoprotein-cholesterol and total cholesterol levels were significantly associated with low total lumbar, femur neck, and total hip BMD, while low-density lipoprotein-cholesterol level was only inversely associated with total lumbar and femur neck BMD. Total cholesterol and low-density lipoprotein-cholesterol levels were also negatively associated with osteocalcin, procollagen type I N-terminal propeptide, and β-crosslaps. In women with T2D, high-density lipoprotein-cholesterol level was observed to be negatively correlated with total lumbar, femur neck, and total hip BMD, while total cholesterol and low-density lipoprotein-cholesterol levels were only associated with BMD at the total lumbar. Furthermore, total cholesterol was also negatively associated with osteocalcin, procollagen type I N-terminal propeptide, and β-crosslaps; high-density lipoprotein-cholesterol was only related to osteocalcin and parathyroid hormone, while low-density lipoprotein-cholesterol was only related to β-crosslaps in women. Conclusion: Our study suggests a significantly negative correlation between serum cholesterol levels and BMD in both men and women with T2D. The associations between serum cholesterol levels and bone turnover markers were also observed in T2D patients.
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Affiliation(s)
- Yinqiu Yang
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guangwang Liu
- Department of Orthopaedics, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou Clinical Medical College of Nanjing University of Chinese Medicine, Xuzhou, China
| | - Yao Zhang
- Department of Endocrinology, Department of Infectious Disease, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guiping Xu
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
- VIP Clinical Department, Fujian Provincial Hospital, Fuzhou, China
| | - Xilu Yi
- Department of Endocrinology, Zhongshan Hospital, Songjiang Central Hospital, Fudan University, Shanghai, China
| | - Jing Liang
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chenhe Zhao
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jun Liang
- Department of Endocrinology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou Clinical Medical College of Nanjing University of Chinese Medicine, Xuzhou, China
| | - Chao Ma
- Department of Orthopaedics, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou Clinical Medical College of Nanjing University of Chinese Medicine, Xuzhou, China
| | - Yangli Ye
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mingxiang Yu
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xinhua Qu
- Department of Bone and Joint Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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18
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Wang Y, Dai J, Zhong W, Hu C, Lu S, Chai Y. Association between Serum Cholesterol Level and Osteoporotic Fractures. Front Endocrinol (Lausanne) 2018; 9:30. [PMID: 29483896 PMCID: PMC5816040 DOI: 10.3389/fendo.2018.00030] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 01/23/2018] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Previous epidemiological studies have found an association between serum cholesterol level and bone mineral density. However, epidemiological studies evaluating the association between serum cholesterol level and the incidence of osteoporotic fracture are scant. Therefore, the objective of this study was to investigate whether serum cholesterol levels in Chinese participants aged 55 years or older was associated with an increased risk of osteoporotic fracture. MATERIALS AND METHODS We performed a cross-sectional study, including 1,791 participants (62.1% postmenopausal women and 213 fractures). Standardized self-administered questionnaires, physical examination, laboratory tests, and dual-energy X-ray absorptiometry examination were performed. Multivariate-adjusted logistic regression models were used to evaluate associations between serum cholesterol [total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C)] levels and the osteoporotic fracture risk. RESULTS After adjusting for potential confounding factors, there were no associations between per SD increase in TC and LDL level and an increased risk of osteoporotic fracture in total participants, and in men and women as individual groups. There was a significant association between per SD increase in HDL-C level and an increased risk of osteoporotic fracture in total participants [odds ratios (OR) 1.20, 95% confidence interval (CI) 1.03, 1.40, P = 0.023] and in women (OR 1.37, 95% CI 1.12, 1.68, P = 0.003), whereas no association was observed in men (OR 1.01, 95% CI 0.73, 1.40, P = 0.951). Additionally, we found a significant association between per SD increase in TG level and an increased risk of osteoporotic fracture in total participants (OR 1.20, 95% CI 1.04, 1.38, P = 0.015). In women, a nonlinear relationship was observed between per SD increase in TG level and an increased risk of osteoporotic fracture. The risk of osteoporotic fracture in women increased with TG level >1.64 mmol/L (OR 1.93, 95% CI 1.24, 3.00, P = 0.004). CONCLUSION Among Chinese older adults, serum HDL-C level is significantly associated with a risk of osteoporotic fractures in women, and serum TG level is significantly associated with a risk of osteoporotic fractures in total participants and in women with TG >1.64 mmol/L.
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Affiliation(s)
- Yanmao Wang
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Jiezhi Dai
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Wanrun Zhong
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Chengfang Hu
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Shengdi Lu
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Shengdi Lu, ; Yimin Chai,
| | - Yimin Chai
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Shengdi Lu, ; Yimin Chai,
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Body adiposity and bone parameters of male rats from mothers fed diet containing flaxseed flour during lactation. J Dev Orig Health Dis 2015; 7:314-319. [DOI: 10.1017/s2040174415007977] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Obesity and osteoporosis may have their origins in early postnatal life. This study was designed to evaluate whether flaxseed flour use during lactation period bears effect on body adiposity and skeletal structure of male rat pups at weaning. At birth, male Wistar rats were randomly assigned to control and experimental (FF) groups, whose dams were treated with control or flaxseed flour diet, respectively, during lactation. At 21 days of age, pups were weaned to assess body mass, length and composition by dual-energy X-ray absorptiometry. The animals were then sacrificed to carry out analysis of serum profile, intra-abdominal adipocyte morphology and femur characteristics. Differences were considered significant when P<0.05. The FF group displayed the following characteristics (P<0.05): higher body mass, length, bone mineral content, bone area and concentrations of osteoprotegerin, osteocalcin and high-density lipoprotein cholesterol; higher levels of stearic, α-linolenic, eicosapentaenoic and docosapentaenoic acids and lower levels of arachidonic acid and cholesterol; smaller adipocyte area; and higher mass, epiphysis distance, diaphysis width, maximal load, break load, resilience and stiffness of femur. Flaxseed flour intake during lactation period promoted adipocyte hypertrophy down-regulation and contributed to pup bone quality at weaning.
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Zheng T, Yang L, Liu Y, Liu H, Yu J, Zhang X, Qin S. Plasma DPP4 Activities Are Associated With Osteoporosis in Postmenopausal Women With Normal Glucose Tolerance. J Clin Endocrinol Metab 2015; 100:3862-70. [PMID: 26259132 DOI: 10.1210/jc.2015-2233] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
CONTEXT Inflammation, insulin resistance, dyslipidemia, and glucagon-like peptide-1 (GLP-1) are risk factors for osteoporosis. Dipeptidyl peptidase-4 (DPP4) is a newly identified adipokine related to these risk factors. OBJECTIVE To investigate the association between plasma DPP4 activities and osteoporosis. DESIGN, SETTING, AND PATIENTS This was a cross-sectional study conducted in Guilin, China. A total of 744 postmenopausal women with normal glucose tolerance were studied. MAIN OUTCOME MEASURES Plasma DPP4 activity, inflammatory markers, blood lipids, homeostatic model assessment of insulin resistance (HOMA-IR), active GLP-1, bone turnover markers, and bone mineral density (BMD) were measured in all participants. RESULTS Participants in the highest quartile of DPP4 activity had higher triglyceride, total cholesterol, HOMA-IR, IL-6, high-sensitivity C-reactive protein (hs-CRP), C-terminal telopeptide of type I collagen, and osteocalcin and lower BMD (lumbar spine and femoral neck) and active GLP-1 compared with participants in the lowest quartile (P < .05). DPP4 activities were associated positively with triglyceride, total cholesterol, HOMA-IR, IL-6, hs-CRP, C-terminal telopeptide of type I collagen, and osteocalcin and negatively with active GLP-1 and BMD (P < .05). In the highest DPP4 quartile, osteoporosis risk was significantly higher (odds ratio, 3.01; 95% confidence interval, 1.66-5.43) than in the lowest quartile after adjustment for potential confounders. The risk for osteoporosis increased more with higher levels of DPP4 activity, HOMA-IR, IL-6, and hs-CRP (P < .05), but not with higher levels of triglyceride and total cholesterol or lower levels of active GLP-1. CONCLUSIONS This study shows that increased DPP4 activities are independently associated with osteoporosis. The mechanisms may be partly explained by the effect of DPP4 on inflammation and insulin resistance.
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Affiliation(s)
- Tianpeng Zheng
- Department of Endocrinology and Metabolism (T.Z., L.Y., J.Y.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Diabetic Centre of Control and Prevention (Y.L.), The People's Liberation Army 520 Hospital, Sichuan 621000, China; Department of Laboratory Medicine (H.L.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Center of Diabetic Systems Medicine (T.Z., X.Z.), Guilin Medical University, Guangxi 541001, People's Republic of China; and Medical Examination Center (S.Q.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China
| | - Liuxue Yang
- Department of Endocrinology and Metabolism (T.Z., L.Y., J.Y.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Diabetic Centre of Control and Prevention (Y.L.), The People's Liberation Army 520 Hospital, Sichuan 621000, China; Department of Laboratory Medicine (H.L.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Center of Diabetic Systems Medicine (T.Z., X.Z.), Guilin Medical University, Guangxi 541001, People's Republic of China; and Medical Examination Center (S.Q.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China
| | - Yihong Liu
- Department of Endocrinology and Metabolism (T.Z., L.Y., J.Y.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Diabetic Centre of Control and Prevention (Y.L.), The People's Liberation Army 520 Hospital, Sichuan 621000, China; Department of Laboratory Medicine (H.L.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Center of Diabetic Systems Medicine (T.Z., X.Z.), Guilin Medical University, Guangxi 541001, People's Republic of China; and Medical Examination Center (S.Q.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China
| | - Hongbo Liu
- Department of Endocrinology and Metabolism (T.Z., L.Y., J.Y.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Diabetic Centre of Control and Prevention (Y.L.), The People's Liberation Army 520 Hospital, Sichuan 621000, China; Department of Laboratory Medicine (H.L.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Center of Diabetic Systems Medicine (T.Z., X.Z.), Guilin Medical University, Guangxi 541001, People's Republic of China; and Medical Examination Center (S.Q.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China
| | - Jian Yu
- Department of Endocrinology and Metabolism (T.Z., L.Y., J.Y.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Diabetic Centre of Control and Prevention (Y.L.), The People's Liberation Army 520 Hospital, Sichuan 621000, China; Department of Laboratory Medicine (H.L.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Center of Diabetic Systems Medicine (T.Z., X.Z.), Guilin Medical University, Guangxi 541001, People's Republic of China; and Medical Examination Center (S.Q.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China
| | - Xiaoxi Zhang
- Department of Endocrinology and Metabolism (T.Z., L.Y., J.Y.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Diabetic Centre of Control and Prevention (Y.L.), The People's Liberation Army 520 Hospital, Sichuan 621000, China; Department of Laboratory Medicine (H.L.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Center of Diabetic Systems Medicine (T.Z., X.Z.), Guilin Medical University, Guangxi 541001, People's Republic of China; and Medical Examination Center (S.Q.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China
| | - Shenghua Qin
- Department of Endocrinology and Metabolism (T.Z., L.Y., J.Y.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Diabetic Centre of Control and Prevention (Y.L.), The People's Liberation Army 520 Hospital, Sichuan 621000, China; Department of Laboratory Medicine (H.L.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China; Center of Diabetic Systems Medicine (T.Z., X.Z.), Guilin Medical University, Guangxi 541001, People's Republic of China; and Medical Examination Center (S.Q.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China
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López-Larramona G, Lucendo AJ, Tenías JM. Association between nutritional screening via the Controlling Nutritional Status index and bone mineral density in chronic liver disease of various etiologies. Hepatol Res 2015; 45:618-28. [PMID: 25059921 DOI: 10.1111/hepr.12395] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 07/04/2014] [Accepted: 07/21/2014] [Indexed: 12/13/2022]
Abstract
AIM Bone density disorders are prevalent in patients with chronic liver disease (CLD), who commonly present with hepatic osteodystrophy. However, the relationship between nutritional status and bone mineral density (BMD) has been scarcely studied in CLD. METHODS This single-center, cross-sectional study included outpatients consecutively diagnosed with CLD during a 1.5-year period. The nutritional status was assessed with the Controlling Nutritional Status (CONUT) index; dual-energy X-ray absorptiometry scans and parameters of bone mineral metabolism were carried out. Bone fracture risk was estimated with the World Health Organization FRAX tool. RESULTS Among the 126 patients recruited (58.7% male), osteopenia and osteoporosis were present in 31.1% and 10.7%, respectively. The 10-year fracture risk was significantly higher among women. Malnutrition estimated with the CONUT index was present in 29.9% of patients and was significantly more frequent in cirrhotic patients, 63.4% of whom were malnourished. Malnutrition stage directly correlated with hepatic function as expressed by the Model for End-Stage Liver Disease index. A non-significant relationship between CONUT-assessed nutritional status and BMD was documented. 25-Hydroxyvitamin-D3 (25[OH]-D3) and fracture risk correlated positively with the CONUT stage, and total cholesterol had an inverse relationship with BMD. CONCLUSION Malnutrition assessed by the CONUT was very frequent in patients with liver cirrhosis. The CONUT score inversely correlated with liver function, while malnutrition stage directly correlated with BMD, fracture risk and 25(OH)-D3. Total cholesterol showed a negative association with BMD in this population.
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Affiliation(s)
| | - Alfredo J Lucendo
- Gastroenterology Department, Hospital General de Tomelloso, Tomelloso, Spain
| | - José María Tenías
- Research Support Unit, Hospital Mancha-Centro, Alcázar de San Juan, Spain
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Mandal CC. High Cholesterol Deteriorates Bone Health: New Insights into Molecular Mechanisms. Front Endocrinol (Lausanne) 2015; 6:165. [PMID: 26557105 PMCID: PMC4617053 DOI: 10.3389/fendo.2015.00165] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 10/08/2015] [Indexed: 01/09/2023] Open
Abstract
Many epidemiological studies show a positive connection between cardiovascular diseases and risk of osteoporosis, suggesting a role of hyperlipidemia and/or hypercholesterolemia in regulating osteoporosis. The majority of the studies indicated a correlation between high cholesterol and high LDL-cholesterol level with low bone mineral density, a strong predictor of osteoporosis. Similarly, bone metastasis is a serious complication of cancer for patients. Several epidemiological and basic studies have established that high cholesterol is associated with increased cancer risk. Moreover, osteoporotic bone environment predisposes the cancer cells for metastatic growth in the bone microenvironment. This review focuses on how cholesterol and cholesterol-lowering drugs (statins) regulate the functions of bone residential osteoblast and osteoclast cells to augment or to prevent bone deterioration. Moreover, this study provides an insight into molecular mechanisms of cholesterol-mediated bone deterioration. It also proposes a potential mechanism by which cellular cholesterol boosts cancer-induced bone metastasis.
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Affiliation(s)
- Chandi C. Mandal
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Rajasthan, India
- *Correspondence: Chandi C. Mandal,
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Garg MK, Marwaha RK, Tandon N, Bhadra K, Mahalle N. Relationship of lipid parameters with bone mineral density in Indian population. Indian J Endocrinol Metab 2014; 18:325-332. [PMID: 24944926 PMCID: PMC4056130 DOI: 10.4103/2230-8210.131165] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Cardiovascular disease and osteoporosis share common risk factors including dyslipidemia. There are conflicting reports of differential relation of various lipid parameters on bone mineral density (BMD). Hence, we studied the correlation between lipid parameters and BMD in healthy adult. MATERIALS AND METHODS A total of 2347 participants (male 39.4%; female 60.6%) included in this cross-sectional study were divided according to sex and age. Fasting blood samples were drawn for biochemical parameters. BMD at lumbar spine, femur, and forearm were measured by dual energy X-ray absorptiometry (DXA). RESULTS In males, BMD at femur and lumbar spine decreased significantly with increasing quartiles of total cholesterol (TC) (P < 0.0001, and 0.004) and low-density lipoprotein cholesterol (LDL-c) (P = 0.001, and 0.01). In premenopausal women, BMD at femoral neck (P = 0.001) and lumbar spine (P = 0.029) showed declining trend with LDL-c (P = 0.007). In postmenopausal women, only BMD at total femur decreased significantly with TC (P = 0.024) and LDL-c (P = 0.036). All above findings were confirmed in correlation studies. In multiple regression analysis after adjusting for age, body mass index, ionized calcium, alkaline phosphatase, 25 hydroxy vitamin D, and parathyroid hormone levels correlation of BMD with TC and LDL-c persisted. TC, LDL-c was higher in subjects with low bone density compared those with normal bone density in both sexes. CONCLUSIONS TC and LDL-c had weak but significant negative correlation with BMD at femur and lumbar spine.
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Affiliation(s)
- M. K. Garg
- Department of Endocrinology and Metabolism, Command Hospital (Southern Command), Pune, Maharastra, India
| | - Raman K. Marwaha
- Department of Endocrinology and Metabolism, International Life Sciences Institute-India, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Kuntal Bhadra
- Department of Endocrinology and Thyroid Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - N. Mahalle
- Department of Pathology, Biochemistry Division, Deenanath Mangeshkar Hospital and Research Center, Erandawane, Pune, Maharashtra, India
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Kim YH, Nam GE, Cho KH, Choi YS, Kim SM, Han BD, Han KD, Lee KS, Park CH, Kim DH. Low bone mineral density is associated with dyslipidemia in South Korean men: the 2008-2010 Korean National Health and Nutrition Examination Survey. Endocr J 2013; 60:1179-89. [PMID: 23877056 DOI: 10.1507/endocrj.ej13-0224] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This study examined the relationship between bone mineral density (BMD) and dyslipidemia in South Korean men. Data from 6,300 men who participated in the Korean National Health and Nutrition Examination Survey from 2008 to 2010 were analyzed, including serum levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) after 8 hours of fasting and mean BMD measured at the lumbar spine (LS), total hip (TH), and femoral neck (FN). Dyslipidemia was defined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III. Other parameters of dyslipidemia were also calculated, such as TG/HDL-C, TC/HDL-C, non-HDL-C (NHDL-C), and LDL-C/HDL-C. Men with dyslipidemia and high levels of TG, TG/HDL-C, TC/HDL-C, NHDL-C, and LDL-C/HDL-C had lower BMD than men without dyslipidemia at the LS, TH, and FN after adjustment for age and body mass index (all p<0.01). On multivariable regression analysis, all odds ratios for high levels of TG, TG/HDL-C, TC/HDL-C, NHDL-C, and LDL-C/HDL-C with an increase in BMD (per standard deviation) were <1 at all 3 sites after adjustment for age and body mass index (model 1). After adjustment for all covariates, only odds ratios for high levels of TG, TG/HDL-C, TC/HDL-C, and NHDL-C were <1 at all 3 sites (model 2), but an increase in BMD was not associated with high LDL-C levels in models 1 and 2. In conclusion, BMD was inversely correlated with parameters of atherogenic dyslipidemia in South Korean men.
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Affiliation(s)
- Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, Korea
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