Lipid metabolism mediates the association between body mass index change and bone mineral density: The Taizhou imaging study

Jiacheng Wang; Yawen Wang; Yi Zheng; Yucan Li; Min Fan; Weizhong Tian; Yanfeng Jiang; Yingzhe Wang; Mei Cui; Chen Suo; Tiejun Zhang; Li Jin; Xingdong Chen; Kelin Xu

doi:10.1016/j.ypmed.2024.107999

Lipid metabolism mediates the association between body mass index change and bone mineral density: The Taizhou imaging study

Prev Med. 2024 May 10:107999. doi: 10.1016/j.ypmed.2024.107999. Online ahead of print.

Authors

Jiacheng Wang¹, Yawen Wang¹, Yi Zheng², Yucan Li², Min Fan³, Weizhong Tian⁴, Yanfeng Jiang⁵, Yingzhe Wang⁶, Mei Cui⁶, Chen Suo⁷, Tiejun Zhang⁸, Li Jin⁵, Xingdong Chen⁹, Kelin Xu¹⁰

Affiliations

¹ School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
² State Key Laboratory of Genetic Engineering, Human Phenome Institute, Fudan University, Shanghai, China.
³ Taixing Disease Control and Prevention Center, Taizhou, Jiangsu, China.
⁴ Department of Medical Imaging, Taizhou People's Hospital Affiliated to Nanjing Medical University, Taizhou, Jiangsu, China.
⁵ State Key Laboratory of Genetic Engineering, Human Phenome Institute, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
⁶ Department of Neurology, Huashan Hospital Affiliated to Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
⁷ School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
⁸ School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China.
⁹ State Key Laboratory of Genetic Engineering, Human Phenome Institute, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital Affiliated to Fudan University, Shanghai, China; Zhangjiang Fudan International Innovation Center, Fudan University, Shanghai, China; Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China. Electronic address: xingdongchen@fudan.edu.cn.
¹⁰ School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China. Electronic address: xukelin@fudan.edu.cn.

PMID: 38735587
DOI: 10.1016/j.ypmed.2024.107999

Abstract

Background: Limited research explores the impact of body mass index (BMI) change on osteoporosis, regarding the role of lipid metabolism. We aimed to cross-sectionally investigate these relationships in 820 Chinese participants aged 55-65 from the Taizhou Imaging Study.

Methods: We used the baseline data collected between 2013 and 2018. T-score was calculated by standardizing bone mineral density and was used for osteoporosis and osteopenia diagnosis. Multinomial logistic regression was used to examine the effect of BMI change on bone health status. Multivariable linear regression was employed to identify the metabolites corrected with BMI change and T-score. Exploratory factor analysis (EFA) and mediation analysis were conducted to ascertain the involvement of the metabolites.

Results: BMI increase served as a protective factor against osteoporosis (OR = 0.79[0.71-0.88], P-value<0.001) and osteopenia (OR = 0.88[0.82-0.95], P-value<0.001). Eighteen serum metabolites were associated with both BMI change and T-score. Specifically, high-density lipoprotein (HDL) substructures demonstrated negative correlations (β = -0.08 to -0.06 and - 0.12 to -0.08, respectively), while very low-density lipoprotein (VLDL) substructions showed positive correlations (β = 0.09 to 0.10 and 0.10 to 0.11, respectively). The two lipid factors (HDL and VLDL) extracted by EFA acted as mediators between BMI change and T-score (Prop. Mediated = 8.16% and 10.51%, all P-value<0.01).

Conclusion: BMI gain among Chinese aged 55-65 is beneficial for reducing the risk of osteoporosis. The metabolism of HDL and VLDL partially mediates the effect of BMI change on bone loss. Our research offers novel insights into the prevention of osteoporosis, approached from the perspective of weight management and lipid metabolomics.

Keywords: BMI change; Bone mineral density; Lipid metabolism; Metabolomics; Osteoporosis.