Medical School of Yan'an University, Yan'an, Shaanxi, China.
Affiliated Hospital of Yan'an University, Yan'an, Shaanxi, China.
Medicine (Baltimore). 2024 Sep 13;103(37):e39612. doi: 10.1097/MD.0000000000039612.
Serum hemoglobin plays an important role in bone metabolism. However, the association between serum hemoglobin levels and bone mineral density (BMD) remains unclear. Therefore, this study aimed to explore the relationship between serum hemoglobin levels and lumbar spine BMD in adults. We conducted a cross-sectional study by utilizing data from the National Health and Nutrition Examination Survey from 2011 to 2018. The serum hemoglobin level was examined as an independent variable, while the lumbar spine BMD was utilized as the dependent variable. Weighted multivariate linear regression models and stratified analysis by age, sex, and race/ethnicity were applied after controlling for confounding factors to assess the relationship between serum hemoglobin levels and the lumbar spine BMD. Additionally, smooth curve fitting and threshold effect analyses were utilized to depict the nonlinear relationship between the 2 variables. A total of 11,658 participants (6004 men and 5654 women) aged ≥ 18 years were included in this study. When the serum hemoglobin level was represented as a continuous variable and fully adjusted in the regression model, the hemoglobin level was significantly negatively correlated with the lumbar spine BMD (β = -0.0035, 95% confidence interval: -0.0065 to -0.0004, P = .024555); this significant negative correlation persisted when the serum hemoglobin level was transformed into a categorical variable, except in the Q2 group (β = -0.0046, 95% confidence interval: -0.0142 to -0.0050, P = .348413). When different confounding factors were used including sex, age, and race/ethnicity, the stratified subgroups exhibited a negative correlation between the serum hemoglobin level and the lumbar spine BMD. Additionally, smooth curve fitting and threshold effect analyses showed a negative correlation between the serum hemoglobin level and the lumbar spine BMD, with a saturation effect at 15 g/dL. Our findings demonstrated an association between hemoglobin levels and the lumbar spine BMD in adults, characterized by a nonlinear relationship. Thus, monitoring the serum hemoglobin level could aid in the early detection of risks associated with bone metabolic disorders such as osteoporosis.
血清血红蛋白在骨骼代谢中起着重要作用。然而，血清血红蛋白水平与骨密度（BMD）之间的关系尚不清楚。因此，本研究旨在探讨成年人血清血红蛋白水平与腰椎 BMD 之间的关系。我们利用 2011 年至 2018 年国家健康和营养调查的数据进行了一项横断面研究。血清血红蛋白水平作为自变量，腰椎 BMD 作为因变量。在控制混杂因素后，采用加权多变量线性回归模型和按年龄、性别和种族/民族分层分析，评估血清血红蛋白水平与腰椎 BMD 之间的关系。此外，还利用平滑曲线拟合和阈值效应分析描绘了这两个变量之间的非线性关系。共有 11658 名年龄≥18 岁的参与者（6004 名男性和 5654 名女性）纳入本研究。当血清血红蛋白水平表示为连续变量并在回归模型中完全调整时，血红蛋白水平与腰椎 BMD 呈显著负相关（β=-0.0035，95%置信区间：-0.0065 至-0.0004，P=0.024555）；当血清血红蛋白水平转换为分类变量时，这种显著的负相关仍然存在，除了 Q2 组（β=-0.0046，95%置信区间：-0.0142 至-0.0050，P=0.348413）。当使用不同的混杂因素，包括性别、年龄和种族/民族时，分层亚组显示血清血红蛋白水平与腰椎 BMD 之间存在负相关。此外，平滑曲线拟合和阈值效应分析显示，血清血红蛋白水平与腰椎 BMD 之间存在负相关，在 15g/dL 时达到饱和效应。本研究结果表明，成年人的血红蛋白水平与腰椎 BMD 之间存在关联，呈非线性关系。因此，监测血清血红蛋白水平有助于早期发现与骨质疏松等骨骼代谢紊乱相关的风险。
