Zeng Jing, Pan Zi-Mo, Li Ting, Chen Ze-Yu, Cai Xiao-Yan, Gong Mei-Liang, Deng Xin-Li, Wang Sheng-Shu, Li Nan, Liu Miao, Li Chun-Lin
Department of Endocrinology, the Second Medical Center and National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, China.
National Key Laboratory of Kidney Disease, Chinese PLA General Hospital, Beijing, China.
J Geriatr Cardiol. 2025 Feb 28;22(2):219-228. doi: 10.26599/1671-5411.2025.02.008.
Early control of low-density lipoprotein cholesterol (LDL-C) is crucial for reducing the progress of cardiovascular disease. However, its additional role to the risk of primary osteoporosis in men with coronary heart disease was inconclusive. Our study aims to determine the association of LDL-C and its trajectories for osteoporosis risk in the middle-aged and aged men of China.
The retrospective cohort study of 1546 men aged 69.74 ± 11.30 years conducted in Beijing, China from 2015 to 2022. And the incidence of primary osteoporosis was annually recorded. LDL-C trajectories were further identified by latent class growth model using repeated measurements of LDL-C. The association of baseline LDL-C for osteoporosis was estimated using hazard ratio (HR) with 95% CI in Cox proportional hazard model, while mean level and trajectories of LDL-C for osteoporosis were evaluated using odds ratio (OR) with 95% CI in logistic regression model.
During the median 6.2-year follow-up period, 70 men developed primary osteoporosis. The higher level of baseline LDL-C (HR = 1.539, 95% CI: 1.012-2.342) and mean LDL-C (OR = 2.190, 95% CI: 1.443-3.324) were associated with higher risk of osteoporosis in men with coronary heart disease after adjusted for covariates. Compared with those in the LDL-C trajectory of low-stable decrease, participants with medium-fluctuant trajectory, whose longitudinal LDL-C started with a medium LDL-C level and appeared an increase and then decrease, were negatively associated with osteoporosis risk (OR = 2.451, 95% CI: 1.152-5.216). And participants with initially high LDL-C level and then a rapid decrease demonstrated a tendency towards reduced risk (OR = 0.718, 95% CI: 0.212-2.437).
Elevated LDL-C level and its long-term fluctuation may increase the risk of primary osteoporosis in men. Early controlling a stable level of LDL-C is also essential for bone health.
早期控制低密度脂蛋白胆固醇（LDL-C）对于减缓心血管疾病进展至关重要。然而，其对冠心病男性原发性骨质疏松风险的额外作用尚无定论。我们的研究旨在确定中国中老年男性中LDL-C及其轨迹与骨质疏松风险的关联。
2015年至2022年在中国北京对1546名年龄为69.74±11.30岁的男性进行回顾性队列研究。每年记录原发性骨质疏松的发病率。使用LDL-C的重复测量值，通过潜在类别增长模型进一步确定LDL-C轨迹。在Cox比例风险模型中使用风险比（HR）及95%置信区间（CI）估计基线LDL-C与骨质疏松的关联，而在逻辑回归模型中使用比值比（OR）及95%CI评估LDL-C的平均水平和轨迹与骨质疏松的关联。
在中位6.2年的随访期内，70名男性发生原发性骨质疏松。在校正协变量后，冠心病男性中较高的基线LDL-C水平（HR = 1.539，95%CI：1.012 - 2.342）和平均LDL-C水平（OR = 2.190，95%CI：1.443 - 3.324）与较高的骨质疏松风险相关。与LDL-C轨迹为低稳定下降的参与者相比，中等波动轨迹的参与者（其纵向LDL-C从中等LDL-C水平开始，先升高后下降）与骨质疏松风险呈负相关（OR = 2.451，95%CI：1.152 - 5.216）。而最初LDL-C水平高然后快速下降的参与者显示出风险降低的趋势（OR = 0.718，95%CI：0.212 - 2.437）。
LDL-C水平升高及其长期波动可能增加男性原发性骨质疏松的风险。早期控制LDL-C的稳定水平对骨骼健康也至关重要。
