Atherogenic lipid profile and elevated lipoprotein (a) are associated with lower bone mineral density in early postmenopausal overweight women

Abstract

Epidemiological studies have reported that women with osteoporosis present an increased risk of cardiovascular events and that lipid lowering therapy (statins) could be associated with a decreased risk of fracture. We investigated whether women with atherogenic lipid profile have lower lumbar and femoral bone mineral density (BMD) and higher prevalence of osteopenia than those with normal lipid levels. The study included 52 overweight early postmenopausal women, with no history of hormone replacement therapy, or any current or past pathology or treatment that could alter bone or lipid metabolism. Atherogenic lipid profile or hyperlipidemia was defined as hypercholesterolemia (> or = 240 mg/dl) or high low-density lipoprotein cholesterol (high-LDLc > or = 160 mg/dl) or high lipoprotein (a) [high-Lp (a) > or =25 mg/dl], and low-BMD as t-score <-1 SD at lumbar o femoral site. The results show that women with hyperlipidemia had lower mean-adjusted BMD (mean+/-SEM) at lumbar (0.865+/-0.020 vs. 0.958+/-0.028 g/cm2, p = 0.007) and femoral neck (0.712+/-0.015 vs. 0.796+/-0.021, p = 0.004 g/cm2) than those with normal lipid levels. Hypercholesterolemia group had higher prevalence of low-BMD at lumbar spine (82.6% vs. 55.2%, p = 0.04, OR: 3.8; 95% CI: 1.04-14.2) and femoral neck (65.2% vs. 37.9%, p = 0.05, OR: 3.1; 95% CI: 0.98-9.6). The high-LDLc group had also higher prevalence low-BMD at femoral neck (75% vs. 39%, p = 0.01, OR: 4.7; 95% CI: 1.26-17.5), and the high-Lp (a) group at lumbar spine (87% vs. 51.7% p = 0.007, OR: 6.2; 95% CI: 1.5-25.6). Women with hyperlipidemia had higher prevalence of low BMD at lumbar spine (81.8% vs. 42.1%, p = 0.003, OR: 6.2; 95% CI: 1.7-22) and femoral neck (60.6% vs. 31.6%, p = 0.04, OR: 3.3; 95% CI: 1.01-11.0). In conclusion, early postmenopausal women with atherogenic lipid profile, defined as cholesterol > or =240 mg/dl or LDLc > or = 160 mg/dl or Lp(a) > or = 25 mg/dl have lower lumbar and femoral BMD and have an increased risk of osteopenia than those with normal lipid profile, suggesting that hyperlipidemia could be associated with osteoporosis and bone status should be evaluated in women with hyperlipidemia.

Increased Bone Turnover in Patients with Hypercholesterolemia

“…PREVIOUS clinical studies have linked osteoporosis with atherosclerosis [1,2] and/or cardiovascular diseases [3,4], suggesting the possibility of a common underlying factor or mechanism among these diseases [5][6][7][8][9][10]. Hypercholesterolemia has been proposed as one of the most likely candidates [5][6][7][8][9][10].…”

“…Hypercholesterolemia has been proposed as one of the most likely candidates [5][6][7][8][9][10]. However, little is known about the precise nature of the potential relationship between hypercholesterolemia and osteoporosis [5][6][7][8][9][10][11][12][13].…”

“…Hypercholesterolemia has been proposed as one of the most likely candidates [5][6][7][8][9][10]. However, little is known about the precise nature of the potential relationship between hypercholesterolemia and osteoporosis [5][6][7][8][9][10][11][12][13]. Several clinical studies [5][6][7][8][9][10][11][12][13] have examined the relationship between hypercholesterolemia and bone mineral density (BMD), but arrived at quite contradictory results.…”

“…However, little is known about the precise nature of the potential relationship between hypercholesterolemia and osteoporosis [5][6][7][8][9][10][11][12][13]. Several clinical studies [5][6][7][8][9][10][11][12][13] have examined the relationship between hypercholesterolemia and bone mineral density (BMD), but arrived at quite contradictory results. Some found an association of hypercholesterolemia with lower BMD [5][6][7][8][9][10], and others with higher BMD [11], while yet others found no association at all [12,13].…”

“…Several clinical studies [5][6][7][8][9][10][11][12][13] have examined the relationship between hypercholesterolemia and bone mineral density (BMD), but arrived at quite contradictory results. Some found an association of hypercholesterolemia with lower BMD [5][6][7][8][9][10], and others with higher BMD [11], while yet others found no association at all [12,13]. On the other hand, both in vitro and in vivo animal model studies have demonstrated some detrimental effects of hypercholesterolemia or dyslipidemia on bone metabolism [14][15][16][17][18][19][20][21][22][23].…”