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      Relationship of lipid parameters with bone mineral density in Indian population

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          Cardiovascular disease and osteoporosis share common risk factors including dyslipidemia. There are conflicting reports of differential relation of various lipid parameters on bone mineral density (BMD). Hence, we studied the correlation between lipid parameters and BMD in healthy adult.

          Materials and Methods:

          A total of 2347 participants (male 39.4%; female 60.6%) included in this cross-sectional study were divided according to sex and age. Fasting blood samples were drawn for biochemical parameters. BMD at lumbar spine, femur, and forearm were measured by dual energy X-ray absorptiometry (DXA).


          In males, BMD at femur and lumbar spine decreased significantly with increasing quartiles of total cholesterol (TC) ( P < 0.0001, and 0.004) and low-density lipoprotein cholesterol (LDL-c) ( P = 0.001, and 0.01). In premenopausal women, BMD at femoral neck ( P = 0.001) and lumbar spine ( P = 0.029) showed declining trend with LDL-c ( P = 0.007). In postmenopausal women, only BMD at total femur decreased significantly with TC ( P = 0.024) and LDL-c ( P = 0.036). All above findings were confirmed in correlation studies. In multiple regression analysis after adjusting for age, body mass index, ionized calcium, alkaline phosphatase, 25 hydroxy vitamin D, and parathyroid hormone levels correlation of BMD with TC and LDL-c persisted. TC, LDL-c was higher in subjects with low bone density compared those with normal bone density in both sexes.


          TC and LDL-c had weak but significant negative correlation with BMD at femur and lumbar spine.

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          Most cited references 37

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          Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report.

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            Relation of body composition, fat mass, and serum lipids to osteoporotic fractures and bone mineral density in Chinese men and women.

            Higher fat mass may be an independent risk factor for osteoporosis and osteoporotic fractures. We aimed to determine the independent contribution of fat mass to osteoporosis and to estimate the risk of osteoporotic fractures in relation to body weight, lean mass, and other confounders. This was a community-based, cross-sectional study of 7137 men, 4585 premenopausal women, and 2248 postmenopausal women aged 25-64 y. Total-body and hip bone mineral content (BMC) and bone mineral density (BMD) and body composition were measured by dual-energy X-ray absorptiometry. Serum lipids were measured. Sex- and menopause-specific multiple generalized linear models were applied. Across 5-kg strata of body weight, fat mass was significantly inversely associated with BMC in the whole body and total hip. When we compared the highest quartile with the lowest quartile of percentage fat mass in men, premenopausal women, and postmenopausal women, the adjusted odds ratios (95% CIs) of osteoporosis defined by hip BMD were 5.2 (2.1, 13.2), 5.0 (1.7, 15.1), and 6.9 (4.3, 11.2), respectively. Significant linear trends existed for higher risks of osteoporosis, osteopenia, and nonspine fractures with higher percentage fat mass. Significant negative relations were found between whole-body BMC and cholesterol, triacylglycerol, LDL, and the ratio of HDL to LDL in all groups. Risks of osteoporosis, osteopenia, and nonspine fractures were significantly higher for subjects with higher percentage body fat independent of body weight, physical activity, and age. Thus, fat mass has a negative effect on bone mass in contrast with the positive effect of weight-bearing itself.
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              Bone loss and the progression of abdominal aortic calcification over a 25 year period: the Framingham Heart Study.

              Vascular calcification and osteoporosis are common age-related processes that are prominently displayed on routine lateral lumbar spine radiographs as dense calcium mineral deposits of the aorta that lie adjacent to osteopenic vertebrae. Using a population-based cohort of older men and women, we tested the hypothesis that the progression of vascular calcification of the abdominal aorta should be greatest in those individuals with the greatest amount of bone loss. From the original population-based Framingham Heart Study cohort, 364 women and 190 men had lateral lumbar spine and hand radiographs performed between 1966 and 1970 and repeated between 1992 and 1993. The lateral lumbar films were read for the presence of aortic calcification using a semiquantitative method, and the hand films were read for second metacarpal relative cortical area (MCA). Using multivariate regression techniques, the 25-year progression of the abdominal aortic calcification index was examined in relation to the change in the MCA, while adjusting for recognized risk factors for atherosclerotic cardiovascular disease. During the 25 years of follow-up, the MCA decreased by 22.4% in women (from 79.6 +/- 7.8 (SD) to 61.8 +/- 10.3) and by 13.3% in men (from 80.6 +/- 6.9 to 69.9 +/- 8.3). The aortic calcification score increased over eightfold in women (from 1.2 +/- 2.7 (SD) to 9.9 +/- 6.7) and sixfold in men (from 1.6 +/- 2.8 to 9.6 +/- 6.3). There was a significant association between percent change in MCA and change in aortic calcification index (P = 0.01) in women after controlling for all potential confounders. No association was observed in men (P = 0.50), including the 50% of men with the greatest bone loss. This is the first longitudinal study to show that women with the greatest magnitude of bone loss also demonstrate the most severe progression of abdominal aortic calcification, suggesting that the two processes may be related.

                Author and article information

                Indian J Endocrinol Metab
                Indian J Endocrinol Metab
                Indian Journal of Endocrinology and Metabolism
                Medknow Publications & Media Pvt Ltd (India )
                May-Jun 2014
                : 18
                : 3
                : 325-332
                Department of Endocrinology and Metabolism, Command Hospital (Southern Command), Pune, Maharastra, India
                [1 ] Department of Endocrinology and Metabolism, International Life Sciences Institute-India, New Delhi, India
                [2 ] Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
                [3 ] Department of Endocrinology and Thyroid Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
                [4 ] Department of Pathology, Biochemistry Division, Deenanath Mangeshkar Hospital and Research Center, Erandawane, Pune, Maharashtra, India
                Author notes
                Corresponding Author: Dr. R. K. Marwaha, Flat No 17, Gautam Apartments, Gautam Nagar, New Delhi - 110 049, India. E-mail: marwaha_ramank@
                Copyright: © Indian Journal of Endocrinology and Metabolism

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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