The Correlation Between the Serum LDL-C/Apo B Ratio and Lumbar Bone Mineral Density in Young Adults

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2023 Mar 23

PMID 36949432

Authors

Anjun Tan

Juntao Shu

Hong Huang

Heng Shao

Jingjing Yang

Affiliations

Soon will be listed here.

Abstract

Background: Numerous studies have confirmed that atherosclerosis is related to osteoporosis (OP), and patients with atherosclerosis are more prone to OP. The ratio of low-density lipoprotein cholesterol (LDL-C) to apolipoprotein B (Apo B) is the valid indicator of atherosclerosis. Nevertheless, conclusions regarding relation between LDL-C/Apo B ratio and bone mineral density (BMD) are still lacking. As a result, this study concentrated on investigating the relationship between LDL-C/Apo B ratio and lumbar BMD in the young adult population according to the National Health and Nutrition Examination Survey (NHANES).

Methods: Information of 2027 young adults (age 20-40 years) from NHANES database was obtained for this cross-sectional study. The correlation between serum LDL-C/Apo B ratio and lumbar BMD was explored through weighted multiple stratified linear regression, while the smooth curve fitting model was utilized for analyzing nonlinear relation. In the nonlinear relation, the inflection point was calculated by saturation threshold analysis. The weighted two-piecewise linear regression model was constructed.

Results: After covariates were adjusted, the relation between serum LDL-C/Apo B ratio and lumbar BMD varied by sex (males: β = -0.0126, 95% CI -0.0892, 0.0640; females: β = 0.0322, 95% CI -0.0367, 0.1011). By performing age-stratified subgroup analysis, the association also varied by age and sex. Males aged 20-30 years presented a negative trend (β = -0.0570, 95% CI -0.1656, 0.0517), and males with the age of 31-40 years showed a positive trend (β = 0.0810, 95% CI -0.0312, 0.1931). Women showed a positive trend by age (females of 20-30 years: β = 0.0051, 95% CI -0.0935, 0.1036; females of 31-40 years: β = 0.0265, 95% CI -0.0767, 0.1296). In race-stratified subgroup analysis, the relations varied by sex and race. To be specific, non-Hispanic black males showed a negative trend (β = -0.0754, 95% CI -0.2695, 0.1188), and males of other races exhibited a positive trend. The trend was positive for women of all races.

Conclusion: Differences were detected in the association between serum LDL-C/Apo B ratio and lumbar BMD among cases aged 20-40 years across sex, age, and race/ethnicity. In addition, the inflection points in U-shaped relationships were also calculated.

Citing Articles

Lipid Metabolism, Methylation Aberrant, and Osteoporosis: A Multi-omics Study Based on Mendelian Randomization.

Zhang Z, Duan Y, Huo J Calcif Tissue Int. 2023; 114(2):147-156.

PMID: 38071623 DOI: 10.1007/s00223-023-01160-6.

Associations between apolipoprotein B and bone mineral density: a population-based study.

Zhao X, Tan N, Zhang Y, Xiao M, Li L, Ning Z BMC Musculoskelet Disord. 2023; 24(1):861.

PMID: 37919727 PMC: 10621203. DOI: 10.1186/s12891-023-06990-x.

References

. Corrigendum to "2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk" [Atherosclerosis 290 (2019) 140-205]. Atherosclerosis. 2019; 294:80-82. DOI: 10.1016/j.atherosclerosis.2019.12.004. View

Zhang Q, Zhou J, Wang Q, Lu C, Xu Y, Cao H . Association Between Bone Mineral Density and Lipid Profile in Chinese Women. Clin Interv Aging. 2020; 15:1649-1664. PMC: 7501971. DOI: 10.2147/CIA.S266722. View

Rabizadeh S, Rajab A, Mechanick J, Moosaie F, Rahimi Y, Nakhjavani M . LDL/apo B ratio predict coronary heart disease in Type 2 diabetes independent of ASCVD risk score: A case-cohort study. Nutr Metab Cardiovasc Dis. 2021; 31(5):1477-1485. DOI: 10.1016/j.numecd.2021.01.013. View

Marcus R . Clinical review 76: The nature of osteoporosis. J Clin Endocrinol Metab. 1996; 81(1):1-5. DOI: 10.1210/jcem.81.1.8550734. View

Scaturro D, Vitagliani F, Terrana P, Tomasello S, Camarda L, Letizia Mauro G . Does the association of therapeutic exercise and supplementation with sucrosomial magnesium improve posture and balance and prevent the risk of new falls?. Aging Clin Exp Res. 2021; 34(3):545-553. PMC: 8894156. DOI: 10.1007/s40520-021-01977-x. View

Boudin E, Van Hul W . MECHANISMS IN ENDOCRINOLOGY: Genetics of human bone formation. Eur J Endocrinol. 2017; 177(2):R69-R83. DOI: 10.1530/EJE-16-0990. View

Chen W, Simpson J, March L, Blyth F, Bliuc D, Tran T . Comorbidities Only Account for a Small Proportion of Excess Mortality After Fracture: A Record Linkage Study of Individual Fracture Types. J Bone Miner Res. 2018; 33(5):795-802. DOI: 10.1002/jbmr.3374. View

Cavalcante L, da Silva E . Application of a modified precipitation method for the measurement of small dense LDL-cholesterol (sd-LDL-C) in a population in southern Brazil. Clin Chem Lab Med. 2012; 50(9):1649-56. DOI: 10.1515/cclm-2011-0797. View

Rubin M . Skeletal fragility in diabetes. Ann N Y Acad Sci. 2017; 1402(1):18-30. DOI: 10.1111/nyas.13463. View

10.

Sato T, Morita I, Murota S . Involvement of cholesterol in osteoclast-like cell formation via cellular fusion. Bone. 1998; 23(2):135-40. DOI: 10.1016/s8756-3282(98)00082-9. View

11.

Griffith J, Yeung D, Tsang P, Choi K, Kwok T, Ahuja A . Compromised bone marrow perfusion in osteoporosis. J Bone Miner Res. 2008; 23(7):1068-75. DOI: 10.1359/jbmr.080233. View

12.

Zhou Y, Deng T, Zhang H, Guan Q, Zhao H, Yu C . Hypercholesterolaemia increases the risk of high‑turnover osteoporosis in men. Mol Med Rep. 2019; 19(6):4603-4612. PMC: 6522796. DOI: 10.3892/mmr.2019.10131. View

13.

Mullen P, Yu R, Longo J, Archer M, Penn L . The interplay between cell signalling and the mevalonate pathway in cancer. Nat Rev Cancer. 2016; 16(11):718-731. DOI: 10.1038/nrc.2016.76. View

14.

Lu C, Liu W, Huang H, Ge X, Hua L, Wang X . The Positive Relationship Between the Low-Density Lipoprotein Cholesterol/Apoprotein B Ratio and Bone Turnover Markers in Patients With Type 2 Diabetes. Front Endocrinol (Lausanne). 2022; 13:903336. PMC: 9223462. DOI: 10.3389/fendo.2022.903336. View

15.

Yerges-Armstrong L, Shen H, Ryan K, Streeten E, Shuldiner A, Mitchell B . Decreased bone mineral density in subjects carrying familial defective apolipoprotein B-100. J Clin Endocrinol Metab. 2013; 98(12):E1999-2005. PMC: 3849668. DOI: 10.1210/jc.2013-2471. View

16.

Opazo-Rios L, Mas S, Marin-Royo G, Mezzano S, Gomez-Guerrero C, Moreno J . Lipotoxicity and Diabetic Nephropathy: Novel Mechanistic Insights and Therapeutic Opportunities. Int J Mol Sci. 2020; 21(7). PMC: 7177360. DOI: 10.3390/ijms21072632. View

17.

Kim H, Oh B, Park-Min K . Regulation of Osteoclast Differentiation and Activity by Lipid Metabolism. Cells. 2021; 10(1). PMC: 7825801. DOI: 10.3390/cells10010089. View

18.

Laroche M, Ludot I, Thiechart M, ARLET J, Pieraggi M, Chiron P . Study of the intraosseous vessels of the femoral head in patients with fractures of the femoral neck or osteoarthritis of the hip. Osteoporos Int. 1995; 5(4):213-7. DOI: 10.1007/BF01774009. View

19.

Pelton K, Krieder J, Joiner D, Freeman M, Goldstein S, Solomon K . Hypercholesterolemia promotes an osteoporotic phenotype. Am J Pathol. 2012; 181(3):928-36. PMC: 3432436. DOI: 10.1016/j.ajpath.2012.05.034. View

20.

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007; 4(10):e296. PMC: 2020495. DOI: 10.1371/journal.pmed.0040296. View