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

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Abstract

Summary

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.

Introduction

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.

Methods

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.

Results

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.

Conclusions

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.

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Abbreviations

HDL-C:

high-density lipoprotein–C

BMI:

body mass index

BMD:

bone mineral density

UA:

uric acid

ALB:

albumin

Ca:

serum–calcium

ALP:

alkaline phosphatase

BUN:

blood urea nitrogen

GLU:

glucose

ALT:

alanine transaminase

AST:

aspartate transaminase

TBIL:

total bilirubin

TC:

total cholesterol

LDL-C:

low-density lipoprotein cholesterol

TG:

triglycerides

CKD–EPI:

Chronic Kidney Disease Epidemiology Collaboration

GFR:

glomerular filtration rate

QC:

quality control

SBP:

systolic blood pressure

DXA:

dual-energy x-ray absorptiometry

CV:

coefficient of variation

eGFR:

estimated renal function

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Funding

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

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Author notes

  1. Jiuzhou Jiang, Pengchen Qiu and Yiyun Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China

    Jiuzhou Jiang, Pengchen Qiu, Yiyun Wang, Chenchen Zhao, Shunwu Fan & Xianfeng Lin

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  1. Jiuzhou Jiang
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  2. Pengchen Qiu
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Jiang, J., Qiu, P., Wang, Y. et al. Association between serum high-density lipoprotein cholesterol and bone health in the general population: a large and multicenter study. Arch Osteoporos 14, 36 (2019). https://doi.org/10.1007/s11657-019-0579-0

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