Plasma Lipids and Osteoporosis in Postmenopausal Women.

Abstract

Many clinical studies have shown that osteoporosis is associated with atherosclerosis and cardiovascular death. Although both high plasma levels of low density lipoprotein cholesterol (LDL-C) and low plasma levels of high density lipoprotein cholesterol (HDL-C) are known to be risk factors for atherosclerosis, it is unclear whether such lipid derangements are also associated with the pathogenesis of osteoporosis. In this study, we evaluated the relationships between plasma levels of total C, LDL-C, HDL-C, or triglyceride (TG) versus bone mineral density (BMD) at the lumbar spine, femoral neck, radius, or total body as well as the presence of vertebral fractures in 214 Japanese postmenopausal women (age range, 47-86 years, mean 62.7). Multiple regression analysis was performed between BMD at each skeletal site versus each lipid level adjusted for age, years after menopause, body mass index (BMI), and %fat. Plasma LDL-C levels were significantly and inversely correlated with the absolute values of both one-third radial (1/3R) and distal radial (UDR) BMD (p<0.01), and tended to be inversely correlated with the absolute values of L-BMD (p=0.051). In contrast, plasma HDL-C levels were significantly and positively correlated with the absolute values of L, 1/3R and UDR BMD (p<0.05). On the other hand, plasma TG levels were significantly lower in women with vertebral fractures than in those without fractures (97.0+/-36.5 vs. 126.4+/-65.8 mg/dl, mean+/-SD, p<0.05). When multivariate logistic regression analysis was performed with the presence of vertebral fractures as a dependent variable and each lipid level adjusted for age, years after menopause, BMI, and %fat as independent variables, TG alone was selected as an index affecting the presence of vertebral fractures (odds ratio: 0.51, 95% confidential interval: 0.29-0.89 per SD increase, p<0.05). Our study showed that plasma LDL-C and HDL-C levels were inversely and positively correlated with both R- and L-BMD values, respectively, while low plasma TG levels were associated with the presence of vertebral fractures in postmenopausal women. Thus, plasma lipids might be related to bone mass and bone fragility, and might be the common factor underlying both osteoporosis and atherosclerosis.

Increased Bone Turnover in Patients with Hypercholesterolemia

“…PREVIOUS clinical studies have linked osteoporosis with atherosclerosis [1,2] and/or cardiovascular diseases [3,4], suggesting the possibility of a common underlying factor or mechanism among these diseases [5][6][7][8][9][10]. Hypercholesterolemia has been proposed as one of the most likely candidates [5][6][7][8][9][10].…”

“…Hypercholesterolemia has been proposed as one of the most likely candidates [5][6][7][8][9][10]. However, little is known about the precise nature of the potential relationship between hypercholesterolemia and osteoporosis [5][6][7][8][9][10][11][12][13].…”

“…Hypercholesterolemia has been proposed as one of the most likely candidates [5][6][7][8][9][10]. However, little is known about the precise nature of the potential relationship between hypercholesterolemia and osteoporosis [5][6][7][8][9][10][11][12][13]. Several clinical studies [5][6][7][8][9][10][11][12][13] have examined the relationship between hypercholesterolemia and bone mineral density (BMD), but arrived at quite contradictory results.…”

“…However, little is known about the precise nature of the potential relationship between hypercholesterolemia and osteoporosis [5][6][7][8][9][10][11][12][13]. Several clinical studies [5][6][7][8][9][10][11][12][13] have examined the relationship between hypercholesterolemia and bone mineral density (BMD), but arrived at quite contradictory results. Some found an association of hypercholesterolemia with lower BMD [5][6][7][8][9][10], and others with higher BMD [11], while yet others found no association at all [12,13].…”

“…Several clinical studies [5][6][7][8][9][10][11][12][13] have examined the relationship between hypercholesterolemia and bone mineral density (BMD), but arrived at quite contradictory results. Some found an association of hypercholesterolemia with lower BMD [5][6][7][8][9][10], and others with higher BMD [11], while yet others found no association at all [12,13]. On the other hand, both in vitro and in vivo animal model studies have demonstrated some detrimental effects of hypercholesterolemia or dyslipidemia on bone metabolism [14][15][16][17][18][19][20][21][22][23].…”