Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
The Second Clinical Medical School, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
Osteoporos Int. 2019 Jul;30(7):1413-1422. doi: 10.1007/s00198-019-04878-y. Epub 2019 Mar 5.
This study is to examine the relationship between body mass index (BMI) and osteoporosis in rural areas of China, and then explore whether this association was mediated by lipid profiles. Results showed that with the increasing of BMI, the risk of osteoporosis was reduced, and lipid profiles mediate this association.
To examine the relationship between BMI and osteoporosis, and explore whether this association was mediated by lipid profiles.
A total of 8272 participants (18-79 years) were enrolled from the Henan Rural Cohort Study. The bone mineral density of the calcaneus was measured using an ultrasonic bone density apparatus. Logistic regression and restricted cubic splines were used to evaluate the odds ratio (OR) and 95% confidence intervals (95% CI). Mediation analysis using bootstrap was performed to examine the contribution of lipid profiles to BMI-related osteoporosis.
The crude and age-standardized prevalence of osteoporosis were 15.93% and 11.77%, respectively. The mean BMIs were 24.12 kg/m for participants with osteoporosis and 25.06 kg/m for non-osteoporosis participants (P < 0.001). After adjusting for potential confounders, subjects with obesity had a lower OR of osteoporosis (0.493 [95% CI: 0.405-0.600], P < 0.001) compared with normal-weight individuals. Mediation analysis showed that lipid profile partly mediated the relationship between BMI and osteoporosis with indirect effect OR (95% CI) of 0.985 (0.978-0.992), and the proportion explained of BMI was 15.48% for lipid profile.
With the increasing of BMI, the risk of osteoporosis was reduced in the Chinese adult population, and lipid profiles may be a potential mediator linking reduced risk of osteoporosis. Elucidating the underlying mechanisms will facilitate developing feasible preventive and therapeutic measures for osteoporosis. Chinese clinical trial register: ChiCTR-OOC-15006699.
研究中国农村地区体重指数（BMI）与骨质疏松症之间的关系，并探讨这种关联是否由血脂水平介导。
本研究共纳入 8272 名（18-79 岁）来自河南农村队列研究的参与者。使用超声骨密度仪测量跟骨的骨密度。采用 logistic 回归和限制性立方样条分析评估比值比（OR）和 95%置信区间（95%CI）。采用 bootstrap 进行中介分析，以检验血脂水平对 BMI 相关骨质疏松症的贡献。
骨质疏松症的粗患病率和年龄标化患病率分别为 15.93%和 11.77%。骨质疏松症患者的平均 BMI 为 24.12kg/m，而非骨质疏松症患者的平均 BMI 为 25.06kg/m（P<0.001）。在调整了潜在混杂因素后，肥胖人群发生骨质疏松症的 OR 较低（0.493[95%CI：0.405-0.600]，P<0.001）。中介分析显示，血脂水平部分介导了 BMI 与骨质疏松症之间的关系，间接效应 OR（95%CI）为 0.985（0.978-0.992），血脂水平对 BMI 的解释比例为 15.48%。
在中国成年人群中，随着 BMI 的增加，骨质疏松症的风险降低，血脂水平可能是联系骨质疏松症风险降低的潜在中介。阐明潜在机制将有助于为骨质疏松症制定可行的预防和治疗措施。
ChiCTR-OOC-15006699。
