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Positive association of high-density lipoprotein cholesterol with lumbar and femoral neck bone mineral density in postmenopausal women

Irene Zolfaroli 1Ester Ortiz 2Miguel-Ángel García-Pérez 3Juan José Hidalgo-Mora 4Juan J Tarín 5Antonio Cano 6

Maturitas. 2021 May;147:41-46.doi: 10.1016/j.maturitas.2021.03.001. Epub 2021 Mar 8.


Objective: Experimental studies suggest that lipids affect bone metabolism. We aimed to elucidate whether lipid levels are associated with bone mineral density (BMD) in a cohort of postmenopausal women.

Design: A cross-sectional study of participants in the Chronic Ailment Reduction after MENopause (CARMEN) cohort. Women underwent assessment of clinical and analytical parameters, including fasting lipid levels. BMD was assessed at both lumbar spine and hip. Homogeneity in the cohort was optimized by filtering out a series of confounding variables with a known impact on bone.

Main outcome measures: Association of BMD at lumbar spine and femoral neck with lipid levels.

Results: A total of 667 of the 1304 screened women were analyzed. A strong correlation was revealed between total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in univariate analysis. Multivariate analysis detected a significant positive association of HDL-C with BMD at both spine (p = 0.007) and femoral neck (p = 0.013). Other independent predictors of spine BMD were years since menopause (ysm, negatively associated), and body mass index (BMI) and estradiol, both positively associated with BMD. The other independent variables in the femoral neck were ysm and glucose (negatively associated) and BMI, estradiol, and phosphate, all positively associated with BMD.

Conclusion: Levels of HDL-C, but not TC, LDL-C or triglycerides, were positively associated with BMD at both the lumbar spine and femoral neck in a homogeneous cohort of postmenopausal women.