Association Between HDL-C and Bone Mineral Density: An Cross-Sectional Analysis

Figures & data

Table 1 Characteristics of Participants (N = 440)

Variables	All N=440
Age (year)	52.5 (43, 61)
Gender (male), n (%)	176 (40)
Current smoker, n (%)	84 (14.9)
Regular drinking (years)	8 (2.5, 27)
Regular exercise, n (%)	321 (72.9)
BMI (kg/m^2)	29.81 (25.5, 34.2)
Average DBP (mmHg)	76 (69, 84)
Average SBP (mmHg)	132 (119, 143)
Heart disease, n (%)	50 (11.3)
Hypertension, n (%)	181 (41.1)
TIA or stroke, n (%)	21 (4.7)
Anemia or blood disease, n (%)	68 (15.4)
Diabetes, n (%)	72 (16.3)
Emphysema/COPD, n (%)	12 (2.7)
Cancer, n (%)	64 (14.5)
Biochemical test
Blood triglycerides (mg/dl)	104 (74, 153)
Blood total cholesterol (mg/dl)	181.5 (160, 209)
Blood HDL-C (mg/dl)	53 (43, 65)
Blood LDL-C (mg/dl)	100 (79.25, 127.75)
BMD-lunar total femur (g/cm^2)	1.02 (0.91, 1.12)
BMD-lunar radius UD (g/cm^2)	0.51 (0.43, 0.57)
BMD-lunar radius 1/3 (g/cm^2)	0.92 (0.84, 1)
BMD-femoral neck (g/cm^2)	0.99 (0.88, 1.11)
T-score lunar total femur	−0.3 (−1, 0.6)
T-score lunar femur neck	−0.6 (−1.3, 0.2)
T-score lunar radius 1/3	−0.1 (−0.8, 0.6)

Abbreviations: BMI, body mass index; DBP, diastolic blood pressure; SBP, systolic blood pressure; TIA, transient ischemic attacks; COPD, chronic obstructive pulmonary disease; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; BMD, bone mineral density; UD, ultradistal.

Table 2 Bivariate Correlations Using Standardized Variables (BMD, N = 440)

Variable	BMD-Lunar Total Femur		BMD-Lunar Radius UD		BMD-Lunar Radius 1/3		BMD-Femoral Neck
	r	P	r	P	r	P	r	P
Triglycerides	0.167	<0.001	0.182	<0.001	0.156	0.001	0.065	0.172
Total Cholesterol	−0.024	0.615	−0.04	0.404	−0.089	0.062	−0.024	0.619
HDL-C	−0.266	<0.001	−0.297	<0.001	−0.307	<0.001	−0.172	<0.001
LDL-C	0.037	0.443	0.028	0.553	−0.012	0.795	0.036	0.45

Abbreviations: HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; BMD, bone mineral density; UD, ultradistal.

Table 3 Bivariate Correlations Using Standardized Variables (T-Score, N = 440)

Variables	T-Score for Lunar Total Femur		T-Score for Lunar Femur Neck		T-Score for Lunar Radius 1/3
	r	P	r	P	r	P
Triglycerides	0.127	0.008	0.041	0.393	0.103	0.031
Total cholesterol	−0.006	0.899	−0.012	0.798	−0.069	0.15
HDL-C	−0.192	<0.001	−0.135	0.005	−0.209	<0.001
LDL-C	0.035	0.464	0.038	0.431	−0.019	0.694

Abbreviations: HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol.

Table 4 Multiple Linear Regression Analysis for Relationship Between Blood Lipid Level and BMD (N = 440)

Variables	BMD-Lunar Total Femur			BMD-Lunar Radius UD			BMD-Lunar Radius 1/3			BMD-Femoral Neck
	B 95% CI	Sβ	P	B 95% CI	Sβ	P	B 95% CI	Sβ	P	B 95% CI	Sβ	P
Model 1
Triglycerides	0 (0, 0)	0.130	0.003	0 (0, 0)	0.100	0.011	0 (0, 0)	0.066	0.062	0 (0, 0)	0.040	0.353
Total Cholesterol	0 (0, 0)	−0.018	0.678	0 (0, 0)	−0.011	0.787	0 (0, 0)	−0.060	0.085	0 (0, 0)	−0.028	0.522
HDL-C	−0.002 (−0.003, −0.001)	−0.181	<0.001	−0.001 (−0.001, 0)	−0.128	0.002	−0.001 (−0.001, 0)	−0.112	0.002	−0.001 (−0.002, 0)	−0.097	0.032
LDL-C	0 (0, 0)	0.006	0.882	0 (0, 0)	0.003	0.944	0 (0, 0)	−0.048	0.169	0 (0, 0)	−0.001	0.982
Model 2
Triglycerides	0 (0, 0)	0.132	0.003	0 (0, 0)	0.103	0.009	0 (0, 0)	0.067	0.055	0 (0, 0)	0.041	0.344
Total Cholesterol	0 (0, 0)	−0.012	0.777	0 (0, 0)	−0.006	0.880	0 (0, 0)	−0.055	0.118	0 (0, 0)	−0.023	0.594
HDL-C	−0.002 (−0.003, −0.001)	−0.179	<0.001	−0.001 (−0.001, 0)	−0.128	0.002	−0.001 (−0.001, 0)	−0.112	0.002	−0.001 (−0.002, 0)	−0.097	0.032
LDL-C	0 (0, 0)	0.011	0.793	0 (0, 0)	0.007	0.861	0 (0, 0)	−0.042	0.230	0 (0, 0)	0.004	0.923
Model 3
Triglycerides	0 (0, 0)	0.118	0.058	0 (0, 0)	0.102	0.011	0 (0, 0)	0.068	0.059	0 (0, 0)	0.030	0.504
Total Cholesterol	0 (0, 0)	−0.005	0.908	0 (0, 0)	−0.001	0.971	0 (0, 0)	−0.049	0.164	0 (0, 0)	−0.016	0.716
HDL-C	−0.002 (−0.002, −0.001)	−0.174	<0.001	−0.001 (−0.001, 0)	−0.127	0.002	−0.001 (−0.001, 0)	−0.109	0.003	−0.001 (−0.002, 0)	−0.093	0.039
LDL-C	0 (0, 0.001)	0.027	0.543	0 (0, 0)	0.014	0.727	0 (0, 0)	−0.036	0.310	0 (0, 0)	0.017	0.703

Notes: Model 1: Adjusted for age and gender. Model 2: Adjusted for age, gender, status of smoke, drink and exercise. Model 3: Adjusted for age, gender, status of smoke, drink and exercise, disease history of heart disease, hypertension, TIA/stroke, anemia/other blood disease, diabetes, emphysema/COPD and cancer.

Abbreviations: BMD, bone mineral density; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; UD, ultradistal; TIA, transient ischemic attacks; COPD, chronic obstructive pulmonary disease.

Figure 1 Corrected smooth curve for high density lipoprotein-cholesterol (HDL-C) and bone mineral density (BMD).

Table 5 Multiple Linear Regression Analysis for Relationship Between Blood Lipid Level and T-Score (N = 440)

Variables	T-Score for Lunar Total Femur			T-Score for Lunar Femur Neck			T-Score for Lunar Radius 1/3
	B 95% CI	Sβ	P	B 95% CI	Sβ	P	B 95% CI	Sβ	P
Model 1
Triglycerides	0.002 (0.001, 0.003)	0.137	0.003	0.001 (−0.001, 0.002)	0.039	0.373	0.001 (0, 0.002)	0.082	0.050
Total Cholesterol	−0.001 (−0.004, 0.002)	−0.022	0.629	−0.01 (−0.003, 0.002)	−0.027	0.539	−0.002 (−0.005, 0)	−0.076	0.070
HDL-C	−0.013 (−0.019, −0.007)	−0.188	<0.001	−0.007 (−0.012, −0.001)	−0.103	0.025	−0.009 (−0.015, −0.003)	−0.137	0.002
LDL-C	0 (−0.003, 0.003)	0.004	0.934	0 (−0.003, 0.003)	0.001	0.989	−0.002 (−0.005, 0.001)	−0.061	0.146
Model 2
Triglycerides	0.002 (0.001, 0.003)	0.137	0.003	0.001 (−0.001, 0.002)	0.039	0.373	0.001 (0, 0.002)	0.082	0.050
Total Cholesterol	0 (−0.003, 0.002)	−0.015	0.737	−0.001 (−0.003, 0.002)	−0.022	0.619	−0.002 (−0.005, 0)	−0.069	0.099
HDL-C	−0.013 (−0.019, −0.007)	−0.185	<0.001	−0.007 (−0.012, −0.001)	−0.103	0.026	−0.009 (−0.015, −0.003)	−0.137	0.002
LDL-C	0 (−0.003, 0.004)	0.010	0.832	0 (−0.003, 0.003)	0.006	0.891	−0.002 (−0.005, 0.001)	−0.053	0.203
Model 3
Triglycerides	0.002 (0, 0.003)	0.121	0.059	0 (−0.001, 0.002)	0.027	0.551	0.001 (0, 0.002)	0.081	0.058
Total Cholesterol	0 (−0.003, 0.003)	−0.008	0.864	0 (−0.003, 0.002)	−0.015	0.730	−0.002 (−0.004, 0.001)	−0.063	0.134
HDL-C	−0.013 (−0.019, −0.006)	−0.181	<0.001	−0.006 (−0.012, −0.001)	−0.099	0.032	−0.009 (−0.015, −0.003)	−0.134	0.002
LDL-C	0.001 (−0.002, 0.004)	0.025	0.577	0.001 (−0.002, 0.004)	0.018	0.682	−0.002 (−0.004, 0.001)	−0.046	0.272

Notes: Model 1: adjusted for age and gender. Model 2: Adjusted for age, gender, status of smoke, drink and exercise. Model 3: Adjusted for age, gender, status of smoke, drink and exercise, disease history of heart disease, hypertension, TIA/stroke, anemia/other blood disease, diabetes, emphysema/COPD and cancer.

Abbreviations: HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TIA, transient ischemic attacks; COPD, chronic obstructive pulmonary disease.

Figure 2 Corrected smooth curve for high density lipoprotein-cholesterol (HDL-C) and T-score.

Table 6 Analysis for Correlations Between Blood HDL-C and BMD and T-Score Stratified by Age, Gender and BMI (N = 440)

Variables	BMD-Lunar Total Femur			T-Score for Lunar Total Femur
	B 95% CI	Sβ	P	B 95% CI	Sβ	P
Age (years)
≤53	−0.002 (−0.003, −0.001)	−0.226	0.001	−0.015 (−0.023, −0.006)	−0.228	0.001
>53	−0.001 (−0.002, 0.001)	−0.087	0.230	−0.006 (−0.017, 0.004)	−0.092	0.235
Gender
Male	−0.001 (−0.003, 0)	−0.144	0.061	−0.10 (−0.20, 0)	−0.144	0.060
Female	−0.001 (−0.002, 0)	−0.139	0.012	−0.10 (−0.019, −0.002)	−0.138	0.013
BMI (kg/m2)
<28	0 (−0.001, 0.001)	−0.028	0.699	−0.001 (−0.010, 0.007)	−0.025	0.749
≥28	−0.001 (−0.002, 0)	−0.130	0.031	−0.010 (−0.018, −0.001)	−0.134	0.028

Note: Adjusted for age, gender, status of smoke, drink and exercise, disease history of heart disease, hypertension, TIA/stroke, anemia/other blood disease, diabetes, emphysema/COPD and cancer.

Abbreviations: BMD, bone mineral density; HDL-C, high-density lipoprotein cholesterol; BMI, body mass index; UD, ultradistal; TIA, transient ischemic attacks; COPD, chronic obstructive pulmonary disease.