Association between Lipids and Bone Mineral Density is Modified by Lipid-Lowering Agents: A Cross-Sectional Study

Introduction: Cardiovascular disease and osteoporosis posed significant public health challenges globally. In human research, lipid-bone mineral density (BMD) associations remained debated. Whether lipid-lowering agents (LLAs) have roles in this relationship remains uncertain. Research aimed to examine the link of lipids and BMD and to test whether these associations were modified by LLAs. Methods: This investigation corporated 3,423 individuals from the National Health and Nutrition Examination Survey. Dual-energy X-ray absorptiometry was used to assess BMD. Multivariable linear regression model was applied to assess correlation between lipids and BMD. Interaction by LLAs were tested to determine their potential modification effects. Results: Average age of individuals for this research was 48.54 ± 0.55 years; male accounted for 56.01%. After adjusting for covariates, total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were related to reduced BMD. Although triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) did not relate with BMD overall, the relationship of TG and BMD was stronger among non-LLA users than LLA users (all P for interaction < 0.05). Associations of HDL-C and lumbar spine BMD were stronger in LLA users ( P for interaction < 0.05). Conclusions: Higher TC and LDL-C levels were related to lower BMD. The association between TG and BMD was stronger among non-LLA users. Association between HDL-C and lumbar spine BMD was stronger among LLA users. However, due to study’s cross-sectional design, causal inferences are limited, and the clinical implications warrant further investigation in longitudinal studies.