Archives of Osteoporosis

, 13:108 | Cite as

Association of high-density lipoprotein, triglycerides, and homocysteine with bone mineral density in young Indian tribal women

  • Rucha Saoji
  • Rajat Subra Das
  • Meena Desai
  • Achhelal Pasi
  • Geetanjali Sachdeva
  • Tapan Kumar Das
  • M. Ikram KhatkhatayEmail author
Original Article



This study investigated association between lipids and homocysteine (Hcy) with bone mineral density (BMD) in young women as opposed to previous studies on elderly women. HDL, triglyceride, and Hcy are significantly associated with BMD in young women and tobacco and alcohol consumption have no effect on this association.


The present study investigates whether the association of serum lipids and homocysteine (Hcy) with bone mineral density (BMD) reported mostly in elderly population can be generalized to young or premenopausal women, consequently suggesting screening of young women with low BMD for dyslipidemia or any cardiovascular events and vice versa.


Women (n = 293, aged 20–47 years) from Northeast India belonging to Tibeto-Burman origin were enrolled. Information about their physical and clinical attributes were collected by a structured questionnaire. Their BMDs at lumbar spine and femur were measured by dual-energy X-ray absorptiometry (DXA) and sera were profiled for lipid parameters and Hcy by auto-analyzer and ELISA, respectively. Women consuming tobacco and/or alcohol were grouped as consumers and others as non-consumers for the analysis.


Positive correlation of BMD with HDL (spine and femur r = 0.38, p < 0.0001) and triglyceride (spine r = 0.534, p < 0.0001; femur r = 0.423, p < 0.0001) was observed, whereas Hcy correlated negatively with BMD (spine r = − 0.189, p = 0.0026; femur r = − 0.273, p < 0.0001). LDL showed a weak negative correlation with BMD (spine r = − 0.128, p = 0.0283; femur r = − 0.199, p = 0.0006). However, after adjusting for age, BMI, and consumption, HDL, triglyceride, and Hcy continued to show significant correlation with BMD at both the sites. Logistic regression analyses indicated that HDL, triglyceride, and Hcy were significant predictors of osteopenia and osteoporosis in our study cohort; however, consumption did not contribute to its prediction.


Low levels of HDL and triglyceride and high levels of Hcy are significantly associated with osteopenia and osteoporosis in young Northeast Indian women.


Young women Indian population Lipids Homocysteine Bone mineral density 



The authors acknowledge Dr. S. D. Mahale, Director, and Dr. S. D. Kholkute, Ex-Director ICMR-NIRRH, Mumbai, for their constant support throughout the study. The authors are also thankful to Ms. Liza Debbarma, Ms. Monika Das, and Ms. Manisha Roy for their help in recruitment of participants and measurement of biochemical parameters.

Funding information

The authors thank the Department of Biotechnology-Northeast (DBT-NE) Twinning Program for funding the study and for the research fellowship awarded to Ms. Rucha Saoji.

Compliance with ethical standards

The study protocol was approved by the Clinical Ethics Committee of Agartala Government Medical College (AGMC), Agartala, and ICMR-National Institute for Research in Reproductive Health Ethics Committee for Clinical Studies, Mumbai (252/2014). Informed consent was obtained from all participants included in the study before their enrolment.

Grant supporters

Department of Biotechnology, Government of India

Conflicts of interest



  1. 1.
    Parthasarathy S, Steinberg D, Witztum J (1992) The role of oxidized low density lipoproteins in the pathogenesis of atherosclerosis. Annu Rev Med 43:219–225PubMedCrossRefGoogle Scholar
  2. 2.
    Wen D, Androjna C, Vasanji A, Belovich J, Midura R (2010) Lipids and collagen matrix restrict the hydraulic permeability within the porous compartment of adult cortical bone. Ann Biomed Eng 38(3):558–569PubMedCrossRefGoogle Scholar
  3. 3.
    Rajendran KG, Chen SY, Sood A, Spielvogel BF, Hall IH (1995) The antiosteoporotic activity of amine-carboxyboranes in rodents. Biomed Pharmacother 49:131–140PubMedCrossRefGoogle Scholar
  4. 4.
    Farhat G, Cauley J (2008) The link between osteoporosis and cardiovascular disease. Clin Cases Miner Bone Metab 5(1):19–34PubMedPubMedCentralGoogle Scholar
  5. 5.
    von der Recke P, Hansen MA, Hassager C (1999) The association between low bone mass at the menopause and cardiovascular mortality. Am J Med 106:273–278PubMedCrossRefGoogle Scholar
  6. 6.
    McFarlane SI, Muniyappa R, Shin JJ, Bahtiyar G, Sowers JR (2004) Osteoporosis and cardiovascular disease: brittle bones and boned arteries, is there a link? Endocrine 23:1–10PubMedCrossRefGoogle Scholar
  7. 7.
    Chen SJ, Lin CS, Lin CL, Kao CH (2015) Osteoporosis is associated with high risk for coronary heart disease: a population-based cohort study. Medicine (Baltimore) 94(27):e1146CrossRefGoogle Scholar
  8. 8.
    Yamaguchi T, Sugimoto T, Yano S et al (2002) Plasma lipids and osteoporosis in postmenopausal women. Endocr J 49:211–217PubMedCrossRefGoogle Scholar
  9. 9.
    Cui LH, Shin MH, Chung EK, Lee YH, Kweon SS, Park KS, Choi JS (2005) Association between bone mineral densities and serum lipid profiles of pre-and post-menopausal rural women in South Korea. Osteoporos Int 16:1975–1981PubMedCrossRefGoogle Scholar
  10. 10.
    Makovey J, Chen JS, Hayward C, Williams FM, Sambrook PN (2009) Association between serum cholesterol and bone mineral density. Bone 44:208–213PubMedCrossRefGoogle Scholar
  11. 11.
    Jeong IK, Cho SW, Kim SW, Choi HJ, Park KS, Kim SY, Lee HK, Cho SH, Oh BH, Shin CS (2010) Lipid profiles and bone mineral density in pre- and postmenopausal women in Korea. Calcif Tissue Int 87:507–512PubMedCrossRefGoogle Scholar
  12. 12.
    Poiana C, Radoi V, Carsote M, Bilezikian JP (2013) New clues that may link osteoporosis to the circulating lipid profile. Bone Research 1(3):260–266PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Bagger YZ, Rasmussen HB, Alexandersen P, Werge T, Christiansen C, Tankó LB, PERF study group (2007) Links between cardiovascular disease and osteoporosis in postmenopausal women: serum lipids or atherosclerosis per se? Osteoporos Int 18(4):505–512PubMedCrossRefGoogle Scholar
  14. 14.
    Dimic A, Popovic MR, Tasic I et al (2012) Relation between bone density and certain parameters of lipid status in postmenopausal women. Cent Eur J Med 7:642Google Scholar
  15. 15.
    Garg M, Marwaha R, Tandon N, Bhadra K, Mahalle N (2014) Relationship of lipid parameters with bone mineral density in Indian population. Indian J Endocrinol Metab 18(3):325–332PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Li S, Guo H, Liu Y, Wu F, Zhang H, Zhang Z, Xie Z, Sheng Z, Liao E (2015) Relationships of serum lipid profiles and bone mineral density in postmenopausal Chinese women. Clin Endocrinol 82:53–58CrossRefGoogle Scholar
  17. 17.
    D’Amelio P, Di BS, Tamone C et al (2008) HDL cholesterol and bone mineral density in normal-weight postmenopausal women: is there any possible association? Panminerva Med 50:89–96PubMedGoogle Scholar
  18. 18.
    Brownbill RA, Ilich JZ (2006) Lipid profile and bone paradox: higher serum lipids are associated with higher bone mineral density in postmenopausal women. J Women's Health (Larchmt) 15(3):261–270CrossRefGoogle Scholar
  19. 19.
    Ghadiri-Anari A, Mortezaii-Shoroki Z, Modarresi M, Dehghan A (2016) Association of lipid profile with bone mineral density in postmenopausal women in Yazd province. Int J Reprod BioMed 14(9):597–602CrossRefGoogle Scholar
  20. 20.
    Dennison E, Syddall H, Sayer A, Martin H, Cooper C (2007) Lipid profile, obesity and bone mineral density: the Hertfordshire cohort study. QJM 100(5):297–303PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Solomon DH, Avorn J, Canning CF, Wang PS (2005) Lipid levels and bone mineral density. Am J Med 118(12):1414PubMedCrossRefGoogle Scholar
  22. 22.
    Samelson EJ, Cupples LA, Hannan MT, Wilson PWF, Williams SA, Vaccarino V, Zhang Y, Kiel DP (2004) Long-term effects of serum cholesterol on bone mineral density in women and men: the Framingham osteoporosis study. Bone 34(3):557–561PubMedCrossRefGoogle Scholar
  23. 23.
    Karthikeyan G, Teo KK, Islam S, McQueen MJ, Pais P, Wang X, Sato H, Lang CC, Sitthi-Amorn C, Pandey MR, Kazmi K, Sanderson JE, Yusuf S (2009) Lipid profile, plasma apolipoproteins, and risk of a first myocardial infarction among Asians: an analysis from the INTERHEART study. J Am Coll Cardiol 53(3):244–253PubMedCrossRefGoogle Scholar
  24. 24.
    Ralston S (2002) Genetic control of susceptibility to osteoporosis. J Clin Endocrinol Metab 87:2460–2466PubMedCrossRefGoogle Scholar
  25. 25.
    Jouanny P, Jeandel C, Pourel J, Guillemin F, Kuntz C (1995) Environmental and genetic factors affecting bone mass similarity of bone density among members of healthy families. Arthritis Rheum 38:61–67PubMedCrossRefGoogle Scholar
  26. 26.
    Ganguly P, Alam S (2015) Role of Hcy in the development of cardiovascular disease. Nutr J 14:6PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Zhang S, Yong-Yi B, Luo LM, Xiao WK, Wu HM, Ye P (2014) Association between serum Hcy and arterial stiffness in elderly: a community-based study. J Geriatr Cardiol 11:32–38PubMedPubMedCentralGoogle Scholar
  28. 28.
    Herrmann M, Widmann T, Herrmann W (2005) Hcy—a newly recognised risk factor for osteoporosis. Clin Chem Lab Med 43:1111–1117PubMedGoogle Scholar
  29. 29.
    Kim BJ, Koh JM, Ahn SH, Lee SH, Kim EH, Bae SJ, Kim HK, Choe JW, Lim KH, Pyun KH, Kim TH, Kim SY, Kim GS (2013) High serum total Hcy levels accelerate hip bone loss in healthy premenopausal women and men. Bone 52(1):56–62PubMedCrossRefGoogle Scholar
  30. 30.
    Bozkurt N, Erdem M, Yilmaz E et al (2009) The relationship of Hcy, B12 and folic acid with the bone mineral density of the femur and lumbar spine in Turkish postmenopausal women. Arch Gynecol Obstet 280(3):381–387PubMedCrossRefGoogle Scholar
  31. 31.
    van Meurs JB, Dhonukshe-Rutten RA, Pluijm SM et al (2004) Hcy levels and the risk of osteoporotic fracture. N Engl J Med 350(20):2033–2041PubMedCrossRefGoogle Scholar
  32. 32.
    Warburton D, Nicol CW, Gatto SN, Bredin S (2007) Cardiovascular disease and osteoporosis: balancing risk management. Vasc Health Risk Manag 3(5):673–689PubMedPubMedCentralGoogle Scholar
  33. 33.
    Martín-González C, González-Reimers E, Quintero-Platt G, Cabrera-García P, Romero-Acevedo L, Gómez-Rodríguez MÁ, Rodríguez Gaspar M, Martínez-Martínez D, Santolaria-Fernández F (2017) Lipid profile and bone mineral density in heavy alcoholics. Clin Nutr.Google Scholar
  34. 34.
    Khadilkar AV, Mandlik RM (2015) Epidemiology and treatment of osteoporosis in women: an Indian perspective. Int J Women’s Health 7:841–850CrossRefGoogle Scholar
  35. 35.
    Ghosh S, Rahaman L, Kaipeng DL, Deb D, Nath N, Tribedi P, Sharma BK (2016) Community-wise evaluation of rice beer prepared by some ethnic tribes of Tripura. J Ethn Foods 3:251–256CrossRefGoogle Scholar
  36. 36.
    Singh A, Ladusingh L (2014) Prevalence and determinants of tobacco use in India: evidence from recent Global Adult Tobacco Survey data. PLoS One 9(12):e114073PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Cullen P (2000) Evidence that triglycerides are an independent coronary heart disease risk factor. Am J Cardiol 86:943–949PubMedCrossRefGoogle Scholar
  38. 38.
    Sommer I, Erkkilä AT, Järvinen R, Mursu J, Sirola J, Jurvelin JS, Kröger H, Tuppurainen M (2013) Alcohol consumption and bone mineral density in elderly women. Public Health Nutr 16(4):704–712PubMedCrossRefGoogle Scholar
  39. 39.
    McLernon DJ, Powell JJ, Jugdaohsingh R, Macdonald HM (2012) Do lifestyle choices explain the effect of alcohol on bone mineral density in women around menopause? Am J Clin Nutr 95(5):1261–1269PubMedCrossRefGoogle Scholar
  40. 40.
    Brien SE, Ronksley PE, Turner BJ, Mukamal KJ, Ghali WA (2011) Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ 342:d636PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    Krenz M, Korthuis RJ (2012) Moderate ethanol ingestion and cardiovascular protection: from epidemiologic associations to cellular mechanisms. J Mol Cell Cardiol 52:93–104PubMedCrossRefGoogle Scholar
  42. 42.
    Quandt SA, Spangler JG, Case LD, Bell RA, Belflower AE (2005) Smokeless tobacco use accelerates age-related loss of bone mineral density among older women in a multi-ethnic rural community. J Cross Cult Gerontol 20(2):109–125PubMedCrossRefGoogle Scholar
  43. 43.
    Tanaka H, Tanabe N, Suzuki N, Shoji M, Torigoe H, Sugaya A, Motohashi M, Maeno M (2005) Nicotine affects mineralized nodule formation by the human osteosarcoma cell line Saos-2. Life Sci 77:2273–2284PubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Rucha Saoji
    • 1
  • Rajat Subra Das
    • 2
  • Meena Desai
    • 1
  • Achhelal Pasi
    • 3
  • Geetanjali Sachdeva
    • 1
  • Tapan Kumar Das
    • 2
  • M. Ikram Khatkhatay
    • 1
    Email author
  1. 1.ICMR-National Institute for Research in Reproductive HealthMumbaiIndia
  2. 2.Agartala Government Medical CollegeAgartalaIndia
  3. 3.Airport Health OrganisationMinistry of Health & Family Welfare (GOI), AndheriMumbaiIndia

Personalised recommendations