L-shaped association of the non-high-density lipoprotein to high-density lipoprotein ratio with low bone mass disorders

Abstract Osteoporosis and osteopenia, collectively referred to as Low Bone Mass Disorders (LBMD), are characterized by decreased bone density and increased fracture risk. Studies have identified a potential link between cardiovascular disease and LBMD, and the role of lipid metabolism in this has at...

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Main Authors: Xiaoteng Chen, Wenyi Du, Hang Li, Jian Wang, Yinkang Wang, Jijun Zhao
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-12806-w
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author Xiaoteng Chen
Wenyi Du
Hang Li
Jian Wang
Yinkang Wang
Jijun Zhao
author_facet Xiaoteng Chen
Wenyi Du
Hang Li
Jian Wang
Yinkang Wang
Jijun Zhao
author_sort Xiaoteng Chen
collection DOAJ
description Abstract Osteoporosis and osteopenia, collectively referred to as Low Bone Mass Disorders (LBMD), are characterized by decreased bone density and increased fracture risk. Studies have identified a potential link between cardiovascular disease and LBMD, and the role of lipid metabolism in this has attracted widespread attention. We analyzed participant information collected from multiple NHANES cycles using weighted multivariable logistic regression, subgroup analysis, restricted cubic splines (RCS) curve analysis, and causal mediation analysis. Non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) was significantly negatively associated with low bone mass disorders in a fully adjusted model. We found that NHHR exhibited an L-shaped relationship with the prevalence of LBMD, with a negative association when NHHR < 3.38 and no significant association when NHHR > 3.38. So we could manage both disorders through NHHR. Causal mediation analysis demonstrated that NHHR was a partial mediator of the effect of body mass index (BMI) on low bone mass disorders (LBMD), accounting for 2.3% of the total effect. This suggests that part of the effect in weight affecting low bone mass disorders is mediated by the NHHR. This inspires us to utilize NHHR to guide weight management.
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spelling doaj-art-ecc361a62ff64e85af5efce83fccddda2025-08-20T04:02:45ZengNature PortfolioScientific Reports2045-23222025-08-0115111210.1038/s41598-025-12806-wL-shaped association of the non-high-density lipoprotein to high-density lipoprotein ratio with low bone mass disordersXiaoteng Chen0Wenyi Du1Hang Li2Jian Wang3Yinkang Wang4Jijun Zhao5Department of Orthopedic, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityDepartment of general Surgery, Yixing People’s Hospital Affiliated to Jiangsu UniversityDepartment of Orthopedic, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityDepartment of Orthopedic, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityWuxi Medical Center of Nanjing Medical UniversityDepartment of Orthopedic, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityAbstract Osteoporosis and osteopenia, collectively referred to as Low Bone Mass Disorders (LBMD), are characterized by decreased bone density and increased fracture risk. Studies have identified a potential link between cardiovascular disease and LBMD, and the role of lipid metabolism in this has attracted widespread attention. We analyzed participant information collected from multiple NHANES cycles using weighted multivariable logistic regression, subgroup analysis, restricted cubic splines (RCS) curve analysis, and causal mediation analysis. Non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) was significantly negatively associated with low bone mass disorders in a fully adjusted model. We found that NHHR exhibited an L-shaped relationship with the prevalence of LBMD, with a negative association when NHHR < 3.38 and no significant association when NHHR > 3.38. So we could manage both disorders through NHHR. Causal mediation analysis demonstrated that NHHR was a partial mediator of the effect of body mass index (BMI) on low bone mass disorders (LBMD), accounting for 2.3% of the total effect. This suggests that part of the effect in weight affecting low bone mass disorders is mediated by the NHHR. This inspires us to utilize NHHR to guide weight management.https://doi.org/10.1038/s41598-025-12806-wLow bone mass disordersNHHRNHANESBMI
spellingShingle Xiaoteng Chen
Wenyi Du
Hang Li
Jian Wang
Yinkang Wang
Jijun Zhao
L-shaped association of the non-high-density lipoprotein to high-density lipoprotein ratio with low bone mass disorders
Scientific Reports
Low bone mass disorders
NHHR
NHANES
BMI
title L-shaped association of the non-high-density lipoprotein to high-density lipoprotein ratio with low bone mass disorders
title_full L-shaped association of the non-high-density lipoprotein to high-density lipoprotein ratio with low bone mass disorders
title_fullStr L-shaped association of the non-high-density lipoprotein to high-density lipoprotein ratio with low bone mass disorders
title_full_unstemmed L-shaped association of the non-high-density lipoprotein to high-density lipoprotein ratio with low bone mass disorders
title_short L-shaped association of the non-high-density lipoprotein to high-density lipoprotein ratio with low bone mass disorders
title_sort l shaped association of the non high density lipoprotein to high density lipoprotein ratio with low bone mass disorders
topic Low bone mass disorders
NHHR
NHANES
BMI
url https://doi.org/10.1038/s41598-025-12806-w
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