Background Elevated total alkaline phosphatase (T-ALP) levels are usually indicative of enhanced osteoblastic activity and bone conversion status and are thus considered as a key factor needed for fresh bone mineralization and synthesis. To date, there is no consistent conclusion on the association between the serum T-ALP levels and bone mineral density (BMD). Therefore, the present study focused on exploring the association of serum T-ALP with lumbar BMD among young adults. Methods The present cross-sectional study included 6,331 subjects included in the National Health and Nutrition Examination Survey (NHANES) during 2011–2016. The participants aged 20–40 years included 3,349 males and 2,982 females. Serum T-ALP was our main variable, lumbar BMD was our outcome variable, and additional variables were the possible impact modifiers. The relations were analysed by the trend study, weighted multiple linear regression models, smooth curve fitting, and stratified analyses. Results In a completely corrected multiple regression model, a negative association between serum T-ALP and lumbar BMD was discovered (β = -0.0007, 95% CI: –0.0009– –0.0005, P < 0.000001). After converting the continuous variable serum T-ALP into the categorical one, the significant negative association was still observed (P < 0.001), and in the subgroup and smooth curve fitting analyses, this negative correlation remained significant, too. Conclusions Our study results indicated that serum T-ALP was negatively associated with lumbar BMD among young adults. Serum T-ALP measurement in the near future might become an effective biomarker to diagnose and treat osteoporosis on time.
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.
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