Garg M K, Marwaha Raman K, Tandon Nikhil, Bhadra Kuntal, Mahalle N
Department of Endocrinology and Metabolism, Command Hospital (Southern Command), Pune, Maharastra, India.
Department of Endocrinology and Metabolism, International Life Sciences Institute-India, New Delhi, India.
Indian J Endocrinol Metab. 2014 May;18(3):325-32. doi: 10.4103/2230-8210.131165.
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.
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).
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.
TC and LDL-c had weak but significant negative correlation with BMD at femur and lumbar spine.
心血管疾病和骨质疏松症有共同的风险因素，包括血脂异常。关于各种脂质参数与骨密度（BMD）之间的差异关系，存在相互矛盾的报道。因此，我们研究了健康成年人脂质参数与BMD之间的相关性。
本横断面研究共纳入2347名参与者（男性占39.4%；女性占60.6%），并按性别和年龄进行分组。采集空腹血样以检测生化参数。采用双能X线吸收法（DXA）测量腰椎、股骨和前臂的骨密度。
在男性中，随着总胆固醇（TC）（P<0.0001和0.004）和低密度脂蛋白胆固醇（LDL-c）（P = 0.001和0.01）四分位数的增加，股骨和腰椎的骨密度显著降低。在绝经前女性中，股骨颈（P = 0.001）和腰椎（P = 0.029）的骨密度随LDL-c升高呈下降趋势（P = 0.007）。在绝经后女性中，仅全股骨的骨密度随TC（P = 0.024）和LDL-c（P = 0.036）显著降低。上述所有结果在相关性研究中均得到证实。在调整年龄、体重指数、离子钙、碱性磷酸酶、25羟维生素D和甲状旁腺激素水平后的多元回归分析中，BMD与TC和LDL-c的相关性依然存在。在男女两性中，骨密度低的受试者的TC、LDL-c均高于骨密度正常的受试者。
TC和LDL-c与股骨和腰椎的骨密度呈弱但显著的负相关。
