Archives of Osteoporosis

, 14:36 | Cite as

Association between serum high-density lipoprotein cholesterol and bone health in the general population: a large and multicenter study

  • Jiuzhou Jiang
  • Pengchen Qiu
  • Yiyun Wang
  • Chenchen Zhao
  • Shunwu FanEmail author
  • Xianfeng LinEmail author
Original Article



This study was a cross-sectional study and enrolled 14,147 participants after excluding. We performed a large number of data analyses to indicate that HDL-C levels were related to bone health. A high HDL-C level is an independent risk factor for bone loss both in males and females.


Serum high-density lipoprotein cholesterol (HDL-C), usually called “good” cholesterol, is beneficial for preventing cardiovascular diseases. Previous studies have indicated that HDL-C levels may be related to bone mass. We performed a cross-sectional study to examine the relationship between HDL-C levels and bone mass, both in men and women.


A total of 14,147 Chinese participants from five medical centers were enrolled in this study. Pearson’s correlation analyses, linear regression analyses, one-way ANOVAs, and logistic regression analyses were performed to assess the relationship between HDL-C levels and bone mass in various cohorts.


Binary logistic regression analyses (after adjusting the confounding factors) indicated that a higher HDL-C level among males leads to a higher risk of at least osteopenia [OR (95% CI) = 1.807 (1.525, 2.142)] and osteoporosis [OR (95% CI) = 1.932 (1.291, 2.892)]. In the female group, the ORs of HDL-C for at least osteopenia [OR (95% CI) = 1.390 (1.100, 1.757)] and osteoporosis [OR (95% CI) = 1.768 (1.221, 2.560)] were still significant after adjusting for potential confounding factors except BMI. Data-standardized bivariate logistic regression analyses indicated that an increase in age is a stronger risk factor for osteoporosis and at least osteopenia than is higher HDL-C levels in females.


A high HDL-C level is an independent risk factor for bone loss both in males and females. Compared with high HDL-C levels, an increase in age and menopause have a much more negative effect on bone mass in females.


High-density lipoprotein cholesterol Risk factor Bone mineral density Osteoporosis 



high-density lipoprotein–C


body mass index


bone mineral density


uric acid






alkaline phosphatase


blood urea nitrogen




alanine transaminase


aspartate transaminase


total bilirubin


total cholesterol


low-density lipoprotein cholesterol




Chronic Kidney Disease Epidemiology Collaboration


glomerular filtration rate


quality control


systolic blood pressure


dual-energy x-ray absorptiometry


coefficient of variation


estimated renal function


Funding information

This work was supported in part by the National Nature Science Fund of China (81702143, 81772387, and 81472064).

Compliance with ethical standards

Conflicts of interest


Supplementary material

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic Surgery, Sir Run Run Shaw HospitalMedical College of Zhejiang UniversityHangzhouChina

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