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. 2023 Jun 15:10:1182866.
doi: 10.3389/fmed.2023.1182866. eCollection 2023.

Apolipoprotein A1 is associated with osteocalcin and bone mineral density rather than high-density lipoprotein cholesterol in Chinese postmenopausal women with type 2 diabetes mellitus

Wei Wang  1 , Zhe Yuan Chen  1 , Fen Yan Lv  1 , Mei Tu  1 , Xiu Li Guo  1
Affiliations

Apolipoprotein A1 is associated with osteocalcin and bone mineral density rather than high-density lipoprotein cholesterol in Chinese postmenopausal women with type 2 diabetes mellitus

Wei Wang et al. Front Med (Lausanne). .

Abstract

Objective: Disturbances in high-density lipoprotein cholesterol (HDL-c) metabolic pathways can affect bone metabolism, which may rely on the particle function of apolipoprotein rather than HDL-c levels. This study aimed to evaluate the correlation of serum HDL-c and apolipoprotein A1 (APOA1) with bone metabolism in Chinese postmenopausal women with type 2 diabetes mellitus (T2DM).

Method: A total of 1,053 participants with complete data were enrolled and separated into three groups based on the HDL-c and APOA1 tertiles. The trained reviewer collected demographic and anthropometric information. Bone turnover markers (BTMs) were determined by standard methods. Bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry.

Results: Overall, the prevalence of osteoporosis was 29.7%. Groups with higher APOA1 have a remarkably more elevated level of osteocalcin (OC), L1-L4 BMD, and T-score across the APOA1 tertiles. APOA1 presented a positive correlation with OC (r = 0.194, p < 0.001), L1-L4 BMD (r = 0.165, p < 0.001), and T-score (r = 0.153, p < 0.001) rather than HDL-c. Meanwhile, APOA1 remained independently associated with OC (β = 0.126, p < 0.001), L1-L4 BMD (β = 0.181, p < 0.001), and T-score (β = 0.180, p < 0.001) after adjustment for confounding factors. APOA1 is also shown to be independently correlated with osteoporosis after adjustment for confounding factors, and the OR (95%CI) was 0.851 (0.784-0.924). In contrast, there was no significant association between HDL-c and osteoporosis. Furthermore, APOA1 seemed to have the largest areas under the curve (AUC) for osteoporosis. The AUC (95% CI) of APOA1 identifying osteoporosis was 0.615 (0.577-0.652). The optimal cut-off value of APOA1 was 0.89 g/L (sensitivity: 56.5%, specificity: 67.9%).

Conclusion: APOA1 is independently associated with OC, L1-L4 BMD, and osteoporosis rather than HDL-c in Chinese postmenopausal women with T2DM.

Keywords: apolipoprotein A1; bone mineral density; bone turnover markers; high-density lipoprotein; osteoporosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart describing the selection process of the study population in this study.
Figure 2
Figure 2
The prevalence of osteoporosis, osteopenia, and normal BMD across the HDL-c (A) and APOA1 (B) tertiles.
Figure 3
Figure 3
Impact of HDL-c and APOA1 on osteoporosis by binomial logistic regression analysis. Model 1: adjusted for age, BMI, diabetic duration, menopausal duration, hypertension, sedentary behavior, smoking, and drinking. Model 2: additional adjustment for HbA1c, TG, HDL-c, APOA1, LDL-c, creatinine, ALT, UA, and HOMA-IR. Model 3: further adjustment for OC, β-CTX, 25-OH-D, iPTH, ALP, calcium, and phosphorous.
Figure 4
Figure 4
Receiver operating characteristic curves for the cutoff value of serum lipids identifying osteoporosis.
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References

    1. Karner Courtney M, Long F. Glucose metabolism in bone. [J]. Bone. (2018) 115:2–7. doi: 10.1016/j.bone.2017.08.008, PMID: - DOI - PMC - PubMed
    1. Sato M, Ye W, Sugihara T, Isaka Y. Fracture risk and healthcare resource utilization and costs among osteoporosis patients with type 2 diabetes mellitus and without diabetes mellitus in Japan: retrospective analysis of a hospital claims database. BMC Musculoskelet Disord. (2016) 17:489. doi: 10.1186/s12891-016-1344-9, PMID: - DOI - PMC - PubMed
    1. Guo Y, Wang Y, Chen F, Wang J, Wang D. Assessment of risk factors for fractures in patients with type 2 diabetes over 60 years old: a cross-sectional study from Northeast China. J Diabetes Res. (2020) 2020:1–8. doi: 10.1155/2020/1508258 - DOI - PMC - PubMed
    1. Napoli N, Schwartz AV, Palermo L, Jin JJ, Wustrack R, Cauley JA, et al. . Risk factors for subtrochanteric and diaphyseal fractures: the study of osteoporotic fractures. J Clin Endocrinol Metab. (2013) 98:659–7. doi: 10.1210/jc.2012-1896, PMID: - DOI - PMC - PubMed
    1. Moseley KF, Du Z, Sacher SE, Ferguson VL, Donnelly E. Advanced glycation endproducts and bone quality: practical implications for people with type 2 diabetes. Curr Opin Endocrinol Diabetes Obes. (2021) 28:360–09. doi: 10.1097/MED.0000000000000641, PMID: - DOI - PubMed