Assessment risk of osteoporosis in Chinese people: relationship among body mass index, serum lipid profiles, blood glucose, and bone mineral density

Figures & data

Table 1 Basic characteristics of the subjects

	Males (n=1,035)	Females (n=3,953)	Z/χ^2	P-valuea
Age (years)	65 (61, 71)	59 (55,65)	22.071	<0.001
Height (cm)	168 (164, 172)	158 (154, 161.5)	39.450	<0.001
Weight (kg)	71 (64, 78)	63 (57, 70)	17.883	<0.001
BMI (kg/m^2)	25.1 (22.72, 27.25)	25.46 (23.19, 27.81)	3.994	<0.001
Waistline (cm)	94 (88, 100)	90 (83, 96)	12.640	<0.001
Hipline (cm)	102 (98, 107)	100 (96, 105)	6.930	<0.001
FBG (mmol/L)	5.88 (5.44, 6.74)	5.64 (5.27, 6.29)	8.554	<0.001
PBG (mmol/L)	8.07 (6.44, 11.2)	7.35 (6.16, 9.72)	5.673	<0.001
Creatinine (μmol/L)	73.4 (67.7, 83)	61.2 (56.6, 66.8)	34.027	<0.001
HDL-C (mmol/L)	1.21 (1.05, 1.43)	1.38 (1.2, 1.6)	14.604	<0.001
LDL-C (mmol/L)	3.09 (2.55, 3.65)	3.36 (2.79, 3.93)	8.563	<0.001
TC (mmol/L)	5.11 (4.49, 5.75)	5.59 (4.94, 6.27)	13.490	<0.001
TG (mmol/L)	1.25 (0.9, 1.79)	1.33 (0.96, 1.89)	3.059	0.002
ALT (U/L)	16 (13, 23)	17 (13, 23)	0.334	0.738
AST (IU/L)	21 (18, 26)	21 (18, 26)	0.202	0.840
GT (IU/L)	28 (20, 41)	21 (16, 31)	13.719	<0.001
HbA-1c (%)	5.8 (5.5, 6.2)	5.9 (5.6, 6.2)	2.070	0.038
BMD (T score)	0.1 (−0.8, 1.4)	−0.9 (−1.7, 0.08)	18.602	<0.001
BMD-stratified (Pb)			14.268	<0.001
Osteoporosis (T ≤−2.5 SD)	13	253
Osteopenia (−2.5< T <−1 SD)	223	1,602
Normal (−1< T <1 SD)	799	2,098

Notes: Data are presented as median with an interquartile range. χ² value is the result of Mann–Whitney test between males and females.

a P<0.05 was considered statistically significant, males vs females.

b P is the value of Kruskal–Wallis test from comparison of different BMD in males and females.

Abbreviations: ALT, alanine transaminase; AST, aspartate aminotransferase; BMD, bone mineral density; BMI, body mass index; FBG, fasting blood glucose; GT, glutamyl transpeptidase; HbA-1c, glycosylated hemoglobin; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; PBG, postprandial blood glucose; SD, standard deviation; TC, total cholesterol; TG, triglyceride.

Table 2 BMD (T score) and OP morbidity in males and females after age-stratified adjustment

Age (years)	Male			Female			Z	P-valuea	χ^2	P-valueb
	N	BMD (T score)	OP (%)	N	BMD (T score)	OP (%)
≤50	25	0.05 (−0.70, 0.95)	0 (0)	264	−0.5 (−1.4, 0.73)	5 (1.89)	0.631	0.578	FISHER	1
51–55	30	−0.21 (−1.08, 1.03)	0 (0)	916	−0.5 (−1.4, 0.4)	22 (2.4)	1.514	0.130	FISHER	1
56–60	187	−0.3 (−1.2, 0.9)	1 (0.53)	1,244	−0.8 (−1.6, 0.08)	54 (4.34)	5.257	<0.001	6.372	0.012
61–65	307	−0.41 (−1.47, 1.15)	4 (1.3)	621	−1.13 (−1.9, −0.15)	54 (8.7)	10.891	<0.001	19.162	<0.001
66–70	220	−0.6 (−1.19, 1.6)	4 (1.82)	393	−1.2 (−1.94, −0.4)	37 (9.41)	11.125	<0.001	13.042	<0.001
71–75	142	−0.72 (−1.43, 1.51)	2 (1.41)	275	−1.3 (−2.1, −0.38)	40 (14.55)	8.952	<0.001	17.843	<0.001
76–80	95	−0.8 (−1.72, 2.23)	1 (1.05)	194	−1.58 (−2.3, −0.7)	33 (17.01)	10.112	<0.001	15.644	<0.001
>80	29	−0.83 (−1.09, 1.97)	1 (3.44)	46	−1.61 (−1.49, 0.83)	8 (17.39)	4.957	<0.001	3.191	0.047

Notes: Data are presented as median with interquartile range. χ² value is the result of Fisher’s exact test between males and females. Z value of Kruskal–Wallis test was from comparison of different age groups. P<0.05 was considered statistically significant,

a P means BMD compared between different age groups;

b P means BMD compared between males and females.

Abbreviations: BMD, bone mineral density; FISHER, Fisher’s exact test; OP, osteoporosis.

Figure 1 Comparison of age-related BMD changes between male and female in lumbar spine.

Abbreviation: BMD, bone mineral density.

Figure 2 Comparison of age-related OP morbidity changes between male and female in lumbar spine.

Abbreviation: OP, osteoporosis.

Table 3 Differences in basic characteristics in males according to bone health classification

Males	OP (n=13)	Osteopenia (n=223)	Normal (n=799)	χ^2	P-value
Age (years)	67 (62.5, 72)	63 (60, 69)	65 (61, 72)a,b	14.420	0.001
Height (cm)	161 (160, 169.5)	168 (164, 172)	168 (164, 172)	4.320	0.115
Weight (kg)	68 (51, 76.5)	69 (62, 75)	71 (64, 78)a,b	8.517	0.014
BMI (kg/m^2)	22.41 (19.83, 26.61)	24.49 (21.97, 26.89)	25.32 (23.01, 27.34)a,b	8.945	0.011
Waistline (cm)	89 (77.5, 98.5)	93 (87, 100)	94 (88, 100)	5.404	0.067
Hipline (cm)	100 (92, 106)	100 (97, 106)	102 (98, 107)a,b	11.599	0.003
FBG (mmol/L)	5.98 (5.45, 6.87)	5.83 (5.41, 6.49)	5.72 (5.24, 6.27)a	7.895	0.035
PBG (mmol/L)	8.17 (6.56, 11.55)	7.59 (6.01, 10.45)	7.85 (5.17, 11.14)a,b	9.344	0.009
Creatinine (μmol/L)	72 (66.35, 78.15)	71 (64.9, 78.5)	74.1 (68.6, 84.8)a,b	25.979	0.000
HDL-C (mmol/L)	1.32 (1.11, 1.61)	1.29 (1.12, 1.51)	1.2 (1.04, 1.41)a	12.029	0.002
LDL-C (mmol/L)	2.71 (2.16, 3.68)	3.15 (2.62, 3.71)	3.09 (2.55, 3.64)	1.847	0.397
TC (mmol/L)	4.76 (4.33, 5.7)	5.17 (4.55, 5.83)	5.09 (4.48, 5.74)	1.252	0.535
TG (mmol/L)	0.89 (0.68, 1.55)	1.11 (0.83, 1.68)	1.28 (0.93, 1.85)a,b	11.379	0.003
ALT (U/L)	13 (11.5, 17.5)	17 (12, 23)	16 (13, 23)	2.700	0.259
AST (IU/L)	21 (17, 23.5)	22 (18, 26)	21 (18, 26)	2.455	0.293
GT (IU/L)	26 (17, 38)	29 (20, 41)	28 (20, 40)	1.338	0.512
HbA-1c (%)	5.8 (5.5, 6.3)	5.9 (5.6, 6.2)	5.7 (5.45, 5.95)	1.006	0.605

Notes: Data are presented as median with interquartile range.

a P is the value of Kruskal–Wallis test from comparison between OP and normal groups.

b P is the value of Kruskal–Wallis test from comparison between osteopenia and normal groups. P<0.05 was considered statistically significant.

Abbreviations: ALT, alanine transaminase; AST, aspartate aminotransferase; BMI, body mass index; FBG, fasting blood glucose; GT, glutamyl transpeptidase; HbA-1c, glycosylated hemoglobin; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; PBG, postprandial blood glucose; TC, total cholesterol; TG, triglyceride; OP, osteoporosis.

Table 4 Differences in basic characteristics in females according to bone health classification

Female	OP (n=253)	Osteopenia (n=1,602)	Normal (n=2,098)	χ^2	P-value
Age (years)	65 (60, 73)	60 (56, 66)	57 (54, 62)a,b	225.494	<0.001
Height (cm)	155 (151, 160)	157 (154, 161)	158.5 (155, 162)b	87.444	<0.001
Weight (kg)	58.5 (52, 65)	62 (57, 68)	64 (59, 70.63)a,b	115.980	<0.001
BMI (kg/m^2)	24.09 (21.64, 26.64)	25.15 (23.01, 27.47)	25.8 (23.5, 28.13)a,b	49.532	<0.001
Waistline (cm)	88 (80, 96)	90 (83, 96)	90 (83, 96)	3.997	0.136
Hipline (cm)	98 (94, 103)	100 (96, 105)	100 (96, 106)b	34.739	<0.001
FBG (mmol/L)	5.87 (5.26, 6.27)	5.63 (5.26, 6.24)	5.52 (5.28, 6.3)	6.167	0.048
PBG (mmol/L)	7.96 (6.26, 10.01)	7.26 (6.1, 9.5)	7.38 (6.19, 9.93)	7.769	0.041
Creatinine (μmol/L)	60.8 (55.6, 66.4)	60.6 (56.28, 66.1)	61.8 (57.1, 67.2)b	21.362	<0.001
HDL-C (mmol/L)	1.43 (1.19, 1.66)	1.41 (1.23, 1.61)	1.35 (1.18, 1.57)b	25.278	<0.001
LDL-C (mmol/L)	3.41 (2.84, 3.9)	3.37 (2.81, 3.94)	3.34 (2.77, 3.91)	2.166	0.339
TC (mmol/L)	5.68 (5.1, 6.33)	5.61 (4.96, 6.29)	5.56 (4.9, 6.24)	2.895	0.235
TG (mmol/L)	1.28 (0.95, 1.73)	1.28 (0.93, 1.82)	1.38 (1, 1.97)a,b	21.698	<0.001
ALT (U/L)	15 (12, 20)	16 (13, 22)	17 (13, 24)	27.505	<0.001
AST (IU/L)	21 (18, 26)	21 (18, 26)	21 (18, 26)	0.053	0.974
GT (IU/L)	19 (14.5, 27)	21 (16, 30.25)	21 (16, 32)b	9.850	0.007
HbA-1c (%)	5.9 (5.6, 6.3)	5.9 (5.6, 6.2)	5.9 (5.6, 6.2)	0.185	0.912

Notes: Data are presented as median with an interquartile range. P<0.05 was considered statistically significant.

a P is the value of Kruskal–Wallis test from comparison between osteopenia and normal groups.

b P is the value of Kruskal–Wallis test from comparison between OP and normal groups.

Abbreviations: ALT, alanine transaminase; AST, aspartate aminotransferase; BMI, body mass index; FBG, fasting blood glucose; GT, glutamyl transpeptidase; HbA-1c, glycosylated hemoglobin; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; OP, osteoporosis; PBG, postprandial blood glucose; TC, total cholesterol; TG, triglyceride.

Table 5 Frequency of BMI, FBG, PBG, and HbA-1c in males and females with OP

Variable	n	OP (%)	χ^2	P-valuea
BMI (kg/m^2)
Male
<18.5	81	1 (1.23)	6.750	0.034
18.5–22.9	192	6 (3.13)
>22.9	762	6 (0.79)
Female
<18.5	86	11 (12.79)	32.429	<0.001
18.5–22.9	803	82 (10.21)
>22.9	3,064	160 (5.22)
FBG (mmol/L)
Male
≤7.0	805	12 (8.94)	2.889	0.047
>7.0	230	1 (0.43)
Female
≤7.0	3,364	217 (6.45)	37.697	<0.001
>7.0	589	36 (6.11)
PBG (mmol/L)
Male
≤11.1	777	10 (1.29)	0.324	0.534
>11.1	258	3 (1.16)
Female
≤11.1	3,190	202 (6.33)	0.127	0.721
>11.1	763	51 (0.1)
HbA-1c (%)
Male
≤6.5	861	12 (1.39)	0.262	0.609
>6.5	174	1 (0.57)
Female
≤6.5	3,349	212 (6.33)	0.179	0.672
>6.5	604	41 (6.79)

Notes: Data are presented as numbers and percentage of each category.

a P<0.05 was considered statistically significant, BMI <18.5 vs >22.9; FBG ≤7.0 vs >7.0; PBG ≤11.1 vs >11.1; HbA-1c ≤6.5 vs >6.5 in OP.

Abbreviations: BMI, body mass index; FBG, fasting blood glucose; HbA-1c, glycosylated hemoglobin; PBG, postprandial blood glucose; OP, osteoporosis.

Table 6 Frequency of lipid profiles in males and females with OP

	n	OP (%)	χ^2	P-valuea
Male
HDL-C			2.013	0.048
≤1.15	414	4 (38.46)
≥1.16	621	9 (61.54)
LDL-C			0.068	0.794
<3.1	520	7 (53.85)
≥3.1	515	6 (46.15)
TC			0.654	0.513
<2.8	4	0 (0)
2.8–5.17	537	8 (61.54)
>5.17	494	5 (38.46)
TG			1.127	0.260
<0.56	44	1 (7.69)
0.56–1.7	700	10 (76.92)
>1.7	291	2 (15.38)
Female
HDL-C			5.440	0.020
≤1.54	2,625	162 (64.03)
≥1.55	1,075	91 (35.97)
LDL-C			1.494	0.222
<3.1	1,502	87 (34.39)
≥3.1	2,451	166 (65.61)
TC			1.516	0.129
<2.8	11	0 (0)
2.8–5.17	1,282	72 (28.46)
>5.17	2,660	181 (71.54)
TG			1.046	0.296
<0.56	120	3 (1.19)
0.56–1.7	2,579	181 (71.54)
>1.7	1,254	69 (27.27)

Notes: Data are presented as numbers and percentage of each category.

a P<0.05 was considered statistically significant, HDL-C ≤1.54 vs ≥1.55; LDL-C <3.1 vs ≥3.1; TC 2.8–5.17 vs >5.17; TG 0.56–1.7 vs >1.7 in OP.

Abbreviations: HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; OP, osteoporosis; TC, total cholesterol; TG, triglyceride.

Table 7 Correlation coefficients among age, height, weight, BMI, waistline, hipline, FBG, HDL-C, LDL-C, TC, TG, and OP in males and females

	OP	Age	Height	Weight	BMI	Waistline	Hipline	FBG	HDL-C	LDL-C	TC	TG
OP		0.168b	0.013	0.132b	0.145b	0.080a	0.113b	0.080a	−0.153b	−0.043	−0.024	0.101b
Age	−0.260b		−0.221b	−0.085b	0.021	0.017	0.012	0.065a	−0.129b	−0.078a	−0.096b	−0.007
Height	0.166b	−0.328b		0.216b	−0.228b	0.154b	0.185b	0.028	0.011	0.022	0.024	0.007
Weight	0.184b	0.002	0.321b		0.873b	0.437b	0.451b	0.103b	−0.194b	0.026	0.020	0.185b
BMI	0.115b	0.171b	−0.144b	0.867b		0.439b	0.436b	0.123b	−0.216b	0.012	0.006	0.207b
Waistline	0.018	0.250b	0.040a	0.604b	0.639b		0.745b	0.154b	−0.290b	0.036	0.020	0.315b
Hipline	0.109b	0.179b	0.118b	0.703b	0.698b	0.706b		0.113b	−0.267b	0.032	0.019	0.245b
FBG	0.113b	0.256b	−0.103b	0.135b	0.193b	0.240b	0.162b		−0.066a	0.070a	0.081b	0.126b
HDL	−0.104b	−0.086b	0.007	−0.220b	−0.240b	−0.232b	−0.223b	−0.176b		0.234b	0.363b	−0.375b
LDL	−0.022	0.083b	−0.058b	0.031	0.064b	0.036a	0.017	0.060b	0.214b		0.844b	0.088b
TC	−0.025	0.108b	−0.073b	−0.007	0.032b	0.002	−0.001	0.085b	0.320b	0.856b		0.271b
TG	0.076b	0.170b	−0.070b	0.226b	0.278b	0.247b	0.233b	0.277b	−0.440b	0.148b	0.296b

Notes: The values in the lower triangle are the Pearson correlation coefficients for females. Pearson correlation coefficients for males are listed in the upper triangle. P<0.05 was considered statistically significant,

a P<0.05;

b P<0.01.

Abbreviations: BMI, body mass index; FBG, fasting blood glucose; HDL, high-density lipoprotein; HDL-C, high-density lipoprotein cholesterol; LDL, low-density lipoprotein; LDL-C, low-density lipoprotein cholesterol; OP, osteoporosis; TC, total cholesterol; TG, triglyceride.