Additional role of low-density lipoprotein cholesterol on the risk of osteoporosis in men with or without coronary heart disease: a real-world longitudinal study

Jing ZENG^{¹^,²^,^*}, Zi-Mo PAN^{¹^,³^,^*}, Ting LI^¹, Ze-Yu CHEN^⁴, Xiao-Yan CAI^⁵, Mei-Liang GONG^⁶, Xin-Li DENG^⁶, Sheng-Shu WANG^⁷, Nan LI^¹(), Miao LIU^{²^,⁸}(), Chun-Lin LI^{¹^,²}()

Department of Endocrinology, the Second Medical Center and National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, China

National Key Laboratory of Kidney Disease, Chinese PLA General Hospital, Beijing, China

Graduate School of Chinese PLA General Hospital, Beijing, China

School of Basic Medicine, Army Medical University, Chongqing, China

Department of Nephrology, the Second Medical Center and National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, China

Department of Clinical Laboratory, the Second Medical Center and National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, China

Institute of Geriatrics, Beijing Key Laboratory of Elderly Comorbidities, the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China

Department of Anti-NBC Medicine, Graduate School of Chinese PLA General Hospital, Beijing, China

^*The authors contributed equally to this manuscript

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Abstract

BACKGROUND

Early control of low-density lipoprotein cholesterol (LDL-C) is crucial for reducing the progress of cardiovascular disease. However, its additional role to the risk of primary osteoporosis in men with coronary heart disease was inconclusive. Our study aims to determine the association of LDL-C and its trajectories for osteoporosis risk in the middle-aged and aged men of China.

METHODS

The retrospective cohort study of 1546 men aged 69.74 ± 11.30 years conducted in Beijing, China from 2015 to 2022. And the incidence of primary osteoporosis was annually recorded. LDL-C trajectories were further identified by latent class growth model using repeated measurements of LDL-C. The association of baseline LDL-C for osteoporosis was estimated using hazard ratio (HR) with 95% CI in Cox proportional hazard model, while mean level and trajectories of LDL-C for osteoporosis were evaluated using odds ratio (OR) with 95% CI in logistic regression model.

RESULTS

During the median 6.2-year follow-up period, 70 men developed primary osteoporosis. The higher level of baseline LDL-C (HR = 1.539, 95% CI: 1.012–2.342) and mean LDL-C (OR = 2.190, 95% CI: 1.443–3.324) were associated with higher risk of osteoporosis in men with coronary heart disease after adjusted for covariates. Compared with those in the LDL-C trajectory of low-stable decrease, participants with medium-fluctuant trajectory, whose longitudinal LDL-C started with a medium LDL-C level and appeared an increase and then decrease, were negatively associated with osteoporosis risk (OR = 2.451, 95% CI: 1.152–5.216). And participants with initially high LDL-C level and then a rapid decrease demonstrated a tendency towards reduced risk (OR = 0.718, 95% CI: 0.212–2.437).

CONCLUSIONS

Elevated LDL-C level and its long-term fluctuation may increase the risk of primary osteoporosis in men. Early controlling a stable level of LDL-C is also essential for bone health.

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References

[1]

Oliva M, Muñoz-Aguirre M, Kim-Hellmuth S, et al. The impact of sex on gene expression across human tissues. Science 2020; 369: eaba3066.