Department of Orthopaedic Surgery, The Second Affiliated Hospital, Yuying Children Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
Lipids Health Dis. 2024 Sep 16;23(1):300. doi: 10.1186/s12944-024-02291-x.
Numerous studies have demonstrated shared risk factors and pathophysiologic mechanisms between osteoporosis and cardiovascular disease. High-density lipoprotein cholesterol (HDL-C) and platelets have long been recognized as crucial factors for cardiovascular health. The platelet to HDL-C ratio (PHR) combines platelet count and high-density lipoprotein cholesterol (HDL-C) level, It is a novel biomarker for metabolic syndrome and cardiovascular disease. The platelet to HDL-C ratio (PHR) possibly reflects the balance between proinflammatory and anti-inflammatory states in the body. Therefore, we hypothesized that changes in PHR ratios may predict a predisposition to pro-inflammatory and increased bone resorption. However, the relationship between the platelet to HDL-C ratio (PHR) and bone mineral density (BMD) remains insufficiently understood. This study aimed to elucidate the relationship between the platelet to HDL-C ratio (PHR) index and bone mineral density (BMD).
Data from the NHANES 2005-2018 were analyzed, excluding adults with missing key variables and specific conditions. Nonlinear relationships were explored by fitting smoothed curves and generalized additive models, with threshold effects employed to calculate inflection points. Additionally, subgroup analyses and interaction tests were conducted.
The study included 13,936 individuals with a mean age of 51.19 ± 16.65 years. Fitted smoothed curves and generalized additive models revealed a nonlinear, inverted U-shaped relationship between the two variables. Threshold effect analysis showed a significant negative association between PHR and total femur bone mineral density (BMD) beyond the inflection point of platelet to HDL-C ratio (PHR) 33.301. Subgroup analyses showed that a significant interaction between these two variables was observed only in the age and sex subgroups (P-interaction < 0.05).
Our study identified a complex, nonlinear, inverted U-shaped relationship between platelet to HDL-C ratio (PHR) and total femur bone mineral density (BMD). These findings underscore the importance of maintaining optimal PHR levels to support bone health, especially in high-risk populations.
大量研究表明，骨质疏松症和心血管疾病之间存在共同的风险因素和病理生理机制。高密度脂蛋白胆固醇（HDL-C）和血小板一直被认为是心血管健康的关键因素。血小板与高密度脂蛋白胆固醇（HDL-C）比值（PHR）结合了血小板计数和高密度脂蛋白胆固醇（HDL-C）水平，是代谢综合征和心血管疾病的新型生物标志物。血小板与高密度脂蛋白胆固醇（HDL-C）比值（PHR）可能反映了体内促炎和抗炎状态之间的平衡。因此，我们假设 PHR 比值的变化可能预示着促炎和骨吸收增加的倾向。然而，血小板与高密度脂蛋白胆固醇（HDL-C）比值（PHR）与骨矿物质密度（BMD）之间的关系尚未得到充分理解。本研究旨在阐明血小板与高密度脂蛋白胆固醇（HDL-C）比值（PHR）指数与骨矿物质密度（BMD）之间的关系。
分析了 2005-2018 年 NHANES 的数据，排除了关键变量和特定条件缺失的成年人。通过拟合平滑曲线和广义加性模型来探索非线性关系，并使用阈值效应来计算拐点。此外，还进行了亚组分析和交互测试。
研究共纳入 13936 名年龄 51.19±16.65 岁的个体。拟合的平滑曲线和广义加性模型显示，这两个变量之间存在非线性的倒 U 形关系。阈值效应分析显示，血小板与高密度脂蛋白胆固醇（HDL-C）比值（PHR）超过 33.301 时，PHR 与总股骨骨矿物质密度（BMD）之间存在显著的负相关关系。亚组分析显示，仅在年龄和性别亚组中观察到这两个变量之间存在显著的交互作用（P 交互<0.05）。
本研究发现，血小板与高密度脂蛋白胆固醇（HDL-C）比值（PHR）与总股骨骨矿物质密度（BMD）之间存在复杂的、非线性的倒 U 形关系。这些发现强调了维持最佳 PHR 水平以支持骨骼健康的重要性，特别是在高危人群中。
