Optimal serum cholesterol concentrations are associated with accelerated bone loss in African ancestry men

Abstract

Purpose Studies of lipid and lipoprotein cholesterol associations with bone mineral density (BMD) and bone loss have been inconclusive, and longitudinal data are sparse. Therefore, the aim of this study was to test if fasting serum lipid and lipoprotein cholesterol levels are associated with areal and volumetric BMD and BMD change, Methods We determined the association of serum triglycerides, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol concentrations with cross-sectional and longitudinal (mean follow-up: 6.1 years) measures of BMD in a cohort of 1289 in African ancestry men (mean age: 56.4 years). Fasting serum triglycerides, HDL and LDL were measured at baseline concurrent with BMD assessments. Dual-energy X-ray absorptiometry was used to quantify integral hip BMD and peripheral quantitative computed tomography at the radius and tibia was used to quantify volumetric BMD. Men were categorized as optimal, borderline or high-risk for triglyceride, HDL and LDL concentrations based on adult treatment panel III guidelines. Results Lower serum triglyceride or LDL and higher HDL concentrations were associated with lower trabecular BMD at baseline (all p<0.05). Similarly, men classified as having optimal levels of LDL, HDL or triglycerides at baseline experienced the greatest integral BMD loss at the hip and trabecular BMD loss at the tibia (all p<0.05), independent of potential confounding factors. Conclusions We found that clinically optimal serum lipid and lipoprotein cholesterol concentrations were associated with accelerated bone loss among Afro-Caribbean men. Further studies are needed to better understand the mechanisms involved and potential clinical significance of these findings.

Association between Serum Cholesterol Level and Osteoporotic Fractures

“…Many studies have investigated the association between serum TG or HDL-C level and BMD. However, the conclusions between studies are controversial ( 8 , 9 , 17 – 27 , 36 – 40 ). In a Dutch cross-sectional, population-based study (including 620 men, 635 women aged 65–88 years), men and women in the highest quartile of HDL-C level had a significantly lower BMD compared with men and women in the lowest quartile ( 37 ).…”

“…A large Swedish study of 6,886 women performed by Lidfeldt et al found a positive correlation between TG level and BMD and a negative correlation between TC or HDL level and BMD ( 38 ). Another cohort of 1,289 African ancestry men with a lower serum TG or LDL and higher HDL level exhibited an association with lower trabecular BMD ( 27 ). Furthermore, a retrospective analysis of data from 4,613 premenopausal women and 2,661 postmenopausal women aged 20–91 years showed no significant relationship between lipid profiles (TC, TG) and total hip, femoral neck, trochanter, or lumbar spine BMD.…”

“…In a Northern Sydney Twin Study, Makovey et al found an inverse relationship between serum TC and LDL levels and lumbar spine and whole body BMD in postmenopausal women as well as between HDL levels and BMD at all sites in premenopausal women ( 9 ). Another cohort including 1,289 African ancestry men reported that lower TG or LDL and higher HDL status were associated with lower trabecular BMD ( 27 ). Moreover, a cross-sectional and a longitudinal study that included 958 Korean postmenopausal women found no association between serum lipid profiles and BMD in postmenopausal women ( 20 ).…”

Association Between Bone Mineral Density, Bone Turnover Markers, and Serum Cholesterol Levels in Type 2 Diabetes

“…In recent years, the association between serum lipid and bone metabolism has gained considerable interest; however, there is no general agreement regarding this subject yet. Retrospective studies conducted in postmenopausal women have reported a negative correlation between serum total cholesterol (TC), LDL-C levels, and bone mineral density (BMD) ( 10 – 12 ), while high-density lipoprotein-cholesterol (HDL-C) level was inversely associated with BMD in both men and women ( 11 , 13 – 16 ). In addition, cholesterol-reducing medication, such as statins, was reported to have beneficial effects on BMD in most previous studies ( 17 – 19 ); this also suggests the negative association between serum cholesterol levels and BMD.…”

Lipid Levels Related to Osteoporosis in Patients with Type 2 Diabetes

“…Some studies suggest that dyslipidemia could result in both increased bone resorption and decreased bone formation [1]. Various studies have tried to evaluate the association between lipid level and osteoporosis, but the results were proved to be controversial [1][2][3][4][5][6][7]. Some studies found an inverse relationship with bone mineral density (BMD) [1][2][3][4][5], whereas others have shown a positive correlation [6] or no correlation [7].…”