Lipid accumulation predicts weaker bones once a critical threshold passes

A study by American adults finds that excess central fat, measured by LAP, is linked to a lower spinal bone density, only after reaching a certain turning point, which suggests a new early alert signal for osteoporosis.

Study: The association between lipid accumulation products and bone mineral density in American adults, a transversal study representative nationwide. Image credit: Crevis / Shuttersock

In a recent study in the journal Scientific Reports, the researchers evaluated the association between a new lipid accumulation indicator, ‘lipid accumulation products (LAP)’ and bone mineral density (DMO). The study data set included 3,883 (Middle Ages = 39.33 years; 45.48% of women) participants of Nhanes with analysis that include subgroups, interaction and threshold analysis, adjusted for covariables.

The study findings revealed a negative non-linear relationship between the LAP and the Lumbar Dmo, with the negative association observed only above a specific LP threshold (LN-Lap ≈ 2.85); Under this value, a significant association was not found. The interaction analysis did not indicate the influence of the subgroups, which suggests that the observed pattern remained through demographic and health characteristics. These findings suggest the clinical utility of LAP as a bioindicator and predictor of osteoporosis, providing valuable ideas that can lead to previous intervention strategies in the treatment of these chronic diseases.

Background

Osteoporosis is a bone condition characterized by severe bone weakening (bone mass reduction), significantly increasing the probability of fracture, especially in adults over 50 years. The chronic condition is a growing public health concern, with an estimated 158 million adults (> 50 years) living with the condition. Alarmingly, the prediction models suggest that this number will only double in 2040, highlighting the need for early prevention, detection and intervention against this social burden.

Previous investigations have established an association between osteoporosis and obesity, and this last significantly exacerbate the risk of the first. Interestingly, validated studies have revealed that the body mass index (BMI) and the circumference of the waist (WC), the most common metrics of obesity, are insufficient predictors of osteoporosis due to the nuanced relationship of the latter with the adipose tissue and the lean tissue.

Lipid accumulation products (LAP) is a relatively novel lipid accumulation score system that combines serum triglycerid levels (TG) with WC to calculate an estimate of central obesity. The measure has been in the center of the recent discussion and scientific research due to the growing evidence that it can predict the risks of several health conditions, including diabetes and other metabolic syndromes, insulin resistance, non -alcoholic fat liver disease and even osteoarthritis. Unfortunately, the association between LAP and osteoporosis (bone mineral density (DMO)) has never been formally established.

About the study

The present study aims to address this knowledge gap and inform future research on interventions against osteoporosis by evaluating the relationship between LAP and BMD in a cohort of the United States (USA) representative at the national level. The study expects to facilitate better recognition, early detection and greater prevention of the future incidence of osteoporosis.

The study data were obtained from the participants of the National Health and Nutrition Examination Survey (Nhanes) program carried out by the US National Health Statistics Center (NChs). UU. The data of four periods of Nhanes survey (2011–2018) were registered, which include demographic data, medical examination, dietary records and questionnaire. Participants under 20 and those with lumbar lumbar data, LAP or covariable data were excluded from subsequent analyzes.

The exposure variable (LAP) was calculated using the following formula: men – WC (cm) –65 × TG (mmol/l), women – WC (cm) –58 × TG (mmol/L). The data for these calculations were obtained from serum sample triglycerides. The result variable (lumbar DMO) was measured using a fan beam densitometer that adjusts to the guidelines of the International Bone Densitometry Society (ISCD).

Interest covariates included age, race, gender, BMI, education, poverty income ratio (PIR), laboratory blood tests, smoking and alcohol status, and chronic disease state. Statistical analyzes were carried out using linear regression models, weighted chi square tests, multivariate linear regression models, threshold effect analysis and interaction analysis.

Study findings

Of the 39,156 records of Nhanes initially registered in the study, 16,539 and 18,374 were excluded depending on the age and missing data, respectively, leaving a final data set of 3,883 participants (Middle Ages = 39.33 years; 45.48% of women). The regression models revealed a negative association between the DMO and lumbar, confirmed by threshold analysis that identified a threshold value for LAP (LN-Lap ≈ 2.85).

It is important to note that the negative association between LAP and DMO was only observed when the LAP values ​​were above this threshold; Below this point, a significant association was not found. Surprisingly, subgroup and interaction analysis failed to highlight the significant impacts of any covariation in the study findings. This indicates that the negative association above the threshold is consisting of different demographic and health groups. In particular, it was observed that associations between LAP and BMD were not linear. Together, these findings suggest the non -exploit potential to take advantage of the return in the early detection of osteoporosis and routine monitoring of general bone health.

The study authors indicate that, although the analysis used a large set of representative data nationwide and adjusted for many possible confusion factors, it is of a transverse nature and, therefore, cannot establish causality. In addition, the analysis was limited to the DMO of the lumbar column, since the relevant data for the femur DM were not available in the used nhanes cycles. More research is needed to clarify the biological mechanisms that link the density of LAP and bone and to verify these findings in prospective studies.

Conclusions

The present study uses a large set of US data. UU. Representative nationwide to establish and describe the relationship between LAP and BMD. The results of the study indicate a non -linear negative correlation between the variables, with a significant association only above a defined LAP threshold, which supports the PL clinical and research utility in future osteoporosis interventions.