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Lipid profiles as potential mediators linking body mass index to osteoporosis among Chinese adults: the Henan Rural Cohort Study

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Abstract

Summary

This study is to examine the relationship between body mass index (BMI) and osteoporosis in rural areas of China, and then explore whether this association was mediated by lipid profiles. Results showed that with the increasing of BMI, the risk of osteoporosis was reduced, and lipid profiles mediate this association.

Introduction

To examine the relationship between BMI and osteoporosis, and explore whether this association was mediated by lipid profiles.

Methods

A total of 8272 participants (18–79 years) were enrolled from the Henan Rural Cohort Study. The bone mineral density of the calcaneus was measured using an ultrasonic bone density apparatus. Logistic regression and restricted cubic splines were used to evaluate the odds ratio (OR) and 95% confidence intervals (95% CI). Mediation analysis using bootstrap was performed to examine the contribution of lipid profiles to BMI-related osteoporosis.

Results

The crude and age-standardized prevalence of osteoporosis were 15.93% and 11.77%, respectively. The mean BMIs were 24.12 kg/m2 for participants with osteoporosis and 25.06 kg/m2 for non-osteoporosis participants (P < 0.001). After adjusting for potential confounders, subjects with obesity had a lower OR of osteoporosis (0.493 [95% CI: 0.405–0.600], Ptrend < 0.001) compared with normal-weight individuals. Mediation analysis showed that lipid profile partly mediated the relationship between BMI and osteoporosis with indirect effect OR (95% CI) of 0.985 (0.978–0.992), and the proportion explained of BMI was 15.48% for lipid profile.

Conclusion

With the increasing of BMI, the risk of osteoporosis was reduced in the Chinese adult population, and lipid profiles may be a potential mediator linking reduced risk of osteoporosis. Elucidating the underlying mechanisms will facilitate developing feasible preventive and therapeutic measures for osteoporosis.

Chinese clinical trial register: ChiCTR-OOC-15006699.

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Acknowledgements

The authors thank all of the participants, coordinators, and administrators for their support and help during the research. In addition, the authors would like to thank Tanko Abdulai for his critical reading of the manuscript.

Availability of data and material

All data generated or analyzed during this study are included in this published article.

Funding

This research was supported by the National Key Research and Development Program of China (Grant No. 2016YFC0900803), National Natural Science Foundation of China (Grant Nos. 81573243, 81602925, U1304821), Henan Provincial Science Fund for Distinguished Young Scholars (Grant No. 164100510021), Science and Technology Innovation Talents Support Plan of Henan Province Colleges and Universities (Grant No. 14HASTIT035), and High-Level Personnel Special Support Project of Zhengzhou University (Grant No. ZDGD13001). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. D.Y. Wu and D. Qiao contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China

    D. Y. Wu & J. Pan

  2. The Second Clinical Medical School, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China

    D. Y. Wu & J. Pan

  3. Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People’s Republic of China

    D. Qiao, X. Zhang, H. Q. Zhang, Z. C. Luo, Y. Wang & C. Wang

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  1. D. Y. Wu
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Contributions

CJW and JP conceived and designed the experiments. DQ, DYW, XZ, HQZ, ZCL, and YW performed and conducted the experiments. DQ, XZ, HQZ, ZCL, and YW analyzed the data and took responsibility for the integrity and accuracy of the information. DQ, DYW, XZ, and HQZ contributed to the reagents/materials/analysis tools. DQ and DYW drafted and revised the manuscript. All authors have approved the final manuscript.

Corresponding authors

Correspondence to J. Pan or C. Wang.

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None.

Ethics approval

Ethics approval was obtained from the “Zhengzhou University Life Science Ethics Committee,” and written informed consent was obtained for all participants. Ethic approval code: [2015] MEC (S128).

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What is already known on this subject?

Previous studies have shown that obesity was associated with osteoporosis, but studies were conducted mostly concentrated on the medical examination crowd. In addition, studies focusing on rural adults are still limited. More importantly, studies exploring whether lipid profile mediates body mass index–related osteoporosis have not been reported yet.

What does this study add?

The results of this study indicated that body mass index was significantly associated with osteoporosis in a Chinese rural population aged 18–79 years. In addition, the present study was the first one examined whether blood lipids mediate BMI-related osteoporosis, and the results indicated that lipid profile partly mediated the relationship between body mass index and osteoporosis. The findings provide evidence to the clinical physicians and public health researchers for future osteoporosis prevention among a high-risk population with low body mass index.

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Wu, D.Y., Qiao, D., Zhang, X. et al. Lipid profiles as potential mediators linking body mass index to osteoporosis among Chinese adults: the Henan Rural Cohort Study. Osteoporos Int 30, 1413–1422 (2019). https://doi.org/10.1007/s00198-019-04878-y

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