Department of Orthopedics, Gusu School, Nanjing Medical University, The First People's Hospital of Kunshan, Suzhou, 215300, Jiangsu, China.
Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China.
J Orthop Surg Res. 2023 Aug 14;18(1):597. doi: 10.1186/s13018-023-04079-8.
In the literature, scarce data investigate the link between 25-hydroxyvitamin D (25[OH]D) and blood lipids in the osteoporosis (OP) population. 25(OH)D, as a calcium-regulating hormone, can inhibit the rise of parathyroid hormone, increase bone mineralization to prevent bone loss, enhance muscle strength, improve balance, and prevent falls in the elderly. This retrospective cross-sectional study aimed to investigate the association between serum 25(OH)D levels and lipid profiles in patients with osteoporosis, with the objective of providing insight for appropriate vitamin D supplementation in clinical settings to potentially reduce the incidence of cardiovascular disease, which is known to be a major health concern for individuals with osteoporosis.
This is a retrospective cross-sectional study from the Affiliated Kunshan Hospital of Jiangsu University, including 2063 OP patients who received biochemical blood analysis of lipids during hospitalization from January 2015 to March 2022. The associations between serum lipids and 25(OH)D levels were examined by multiple linear regression. The dependent variables in the analysis were the concentrations of serum lipoprotein, total cholesterol (TC), triglycerides (TGs), apolipoprotein-A, lipoprotein A, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol (LDL-C). The independent variable was the concentration of blood serum 25(OH)D. At the same time, age, body mass index, sex, time and year of serum analysis, primary diagnosis, hypertension, diabetes, statins usage, beta-C-terminal telopeptide of type I collagen, procollagen type I N-terminal propeptide were covariates. Blood samples were collected in the early morning after the overnight fasting and were analyzed using an automated electrochemiluminescence immunoassay on the LABOSPECT 008AS platform (Hitachi Hi-Tech Co., Ltd., Tokyo, Japan). The generalized additive model was further applied for nonlinear associations. The inception result for smoothing the curve was evaluated by two-piecewise linear regression exemplary.
Our results proved that in the OP patients, the serum 25(OH)D levels were inversely connected with blood TGs concentration, whereas they were positively associated with the HDL, apolipoprotein-A, and lipoprotein A levels. In the meantime, this research also found a nonlinear relationship and threshold effect between serum 25(OH)D and TC, LDL-C. Furthermore, there were positive correlations between the blood serum 25(OH)D levels and the levels of TC and LDL-C when 25(OH)D concentrations ranged from 0 to 10.04 ng/mL. However, this relationship was not present when 25(OH)D levels were higher than 10.04 ng/mL.
Our results demonstrated an independent relationship between blood lipids and vitamin D levels in osteoporosis patients. While we cannot establish a causal relationship between the two, our findings suggest that vitamin D may have beneficial effects on both bone health and blood lipid levels, providing a reference for improved protection against cardiovascular disease in this population. Further research, particularly interventional studies, is needed to confirm these associations and investigate their underlying mechanisms.
在文献中,很少有数据研究 25-羟维生素 D(25[OH]D)与骨质疏松症(OP)人群中血脂之间的联系。25(OH)D 作为一种钙调节激素,可抑制甲状旁腺激素升高,增加骨矿化以防止骨质流失,增强肌肉力量,改善平衡,预防老年人跌倒。本回顾性横断面研究旨在探讨血清 25(OH)D 水平与骨质疏松症患者血脂谱之间的关系,目的是为临床适当补充维生素 D 提供依据,以潜在降低心血管疾病的发病率,这是骨质疏松症患者的一个主要健康问题。
这是一项来自江苏大学附属医院的回顾性横断面研究,纳入了 2063 名 2015 年 1 月至 2022 年 3 月期间因住院接受血脂生化血液分析的 OP 患者。采用多元线性回归分析血清脂质与 25(OH)D 水平之间的关系。分析中的因变量是血清脂蛋白、总胆固醇(TC)、甘油三酯(TGs)、载脂蛋白-A、脂蛋白 A、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇(LDL-C)的浓度。自变量为血血清 25(OH)D 浓度。同时,年龄、体重指数、性别、血清分析时间和年份、主要诊断、高血压、糖尿病、他汀类药物使用、I 型胶原β-C 端端肽、I 型前胶原 N 端前肽作为协变量。采集清晨空腹过夜后的血液样本,在 LABOSPECT 008AS 平台(日立高新株式会社,东京,日本)上采用自动电化学发光免疫分析进行分析。进一步应用广义加性模型进行非线性关联分析。通过两段线性回归示例评估平滑曲线的起始结果。
我们的研究结果表明,在 OP 患者中,血清 25(OH)D 水平与血液 TGs 浓度呈负相关,而与 HDL、载脂蛋白-A 和脂蛋白 A 水平呈正相关。同时,本研究还发现血清 25(OH)D 与 TC、LDL-C 之间存在非线性关系和阈值效应。此外,当血清 25(OH)D 浓度在 0 到 10.04ng/mL 之间时,血清 25(OH)D 水平与 TC 和 LDL-C 水平之间存在正相关关系。然而,当 25(OH)D 水平高于 10.04ng/mL 时,这种关系并不存在。
我们的研究结果表明,骨质疏松症患者的血脂与维生素 D 水平之间存在独立关系。虽然我们不能确定两者之间存在因果关系,但我们的研究结果表明,维生素 D 可能对骨骼健康和血脂水平都有有益的影响,为改善该人群的心血管疾病保护提供了参考。需要进一步的研究,特别是干预性研究,以证实这些关联并研究其潜在机制。