Wei Hua, Jin Ziqi, Zhou Liangji, Tang Gangjian, Chai Sheng, Che Xiaoqiao, Tan Yongxing, Zeng Weiqing
Department of Orthopedics, Guilin Municipal Hospital of Traditional Chinese Medicine, Guilin, Guangxi, China.
Graduate College, Guangxi University of Chinese Medicine, Nanning, Guangxi, China.
Front Endocrinol (Lausanne). 2025 Apr 28;16:1559043. doi: 10.3389/fendo.2025.1559043. eCollection 2025.
Postmenopausal women are at an increased risk of bone density reduction, with multiple factors implicated, including folate, a B vitamin whose impact on bone health is gaining attention. The purpose of this research was to examine the association between red blood cell (RBC) folate levels and lumbar bone mineral density (BMD) in postmenopausal women.
We performed a cross-sectional study to investigate the association between postmenopausal women's lumbar BMD and RBC folate levels, using the data from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). Participants were categorized into quartiles based on RBC folate levels (Q1-Q4). Univariate and multivariate regression models assessed the association between RBC folate levels and lumbar BMD, with threshold effect analysis performed.
A total of 1315 postmenopausal women were included. RBC folate levels were positively associated with lumbar BMD. The trend analysis across the quartiles of RBC folate indicated a statistically significant trend in all models (P for trend: Model 1 = 0.020; Model 2 = 0.015; Model 3 = 0.037), suggesting that higher RBC folate levels are associated with increased lumbar BMD. In the unadjusted model 1, a 10 nmol/L increase in RBC folate was associated with a 0.0002 g/cm² increase in lumbar BMD (P=0.002509). The correlation was still significant (P=0.0006) even after age and race were taken into account (model 2). Further adjustment for multiple variables (model 3) showed a 0.0002 g/cm² increase in lumbar BMD per 10 nmol/L increase in RBC folate (P=0.0212). Threshold effect analysis revealed a breakpoint at 92.4 nmol/dL, suggesting a nonlinear relationship between RBC folate levels and lumbar BMD.
Postmenopausal women's RBC folate levels had a positive association with their lumbar BMD. Maintaining appropriate RBC folate levels may help preserve bone density and offer a fresh approach to avoiding osteoporosis in postmenopausal women.
绝经后女性骨密度降低的风险增加，涉及多种因素，包括叶酸，一种对骨骼健康的影响正受到关注的B族维生素。本研究的目的是探讨绝经后女性红细胞（RBC）叶酸水平与腰椎骨密度（BMD）之间的关联。
我们进行了一项横断面研究，利用2009 - 2018年美国国家健康与营养检查调查（NHANES）的数据，调查绝经后女性腰椎BMD与RBC叶酸水平之间的关联。参与者根据RBC叶酸水平分为四分位数（Q1 - Q4）。单变量和多变量回归模型评估RBC叶酸水平与腰椎BMD之间的关联，并进行阈值效应分析。
共纳入1315名绝经后女性。RBC叶酸水平与腰椎BMD呈正相关。在所有模型中，RBC叶酸四分位数的趋势分析显示出统计学上的显著趋势（趋势P值：模型1 = 0.020；模型2 = 0.015；模型3 = 0.037），表明较高的RBC叶酸水平与腰椎BMD增加相关。在未调整的模型1中，RBC叶酸每增加10 nmol/L，腰椎BMD增加0.0002 g/cm²（P = 0.002509）。即使在考虑年龄和种族后（模型2），相关性仍然显著（P = 0.0006）。进一步对多个变量进行调整（模型3）显示，RBC叶酸每增加10 nmol/L，腰椎BMD增加0.0002 g/cm²（P = 0.0212）。阈值效应分析显示在92.4 nmol/dL处有一个断点，表明RBC叶酸水平与腰椎BMD之间存在非线性关系。
绝经后女性的RBC叶酸水平与其腰椎BMD呈正相关。维持适当的RBC叶酸水平可能有助于保持骨密度，并为预防绝经后女性骨质疏松症提供一种新方法。
