AUTHOR=Lu Chun-feng , Liu Wang-shu , Huang Hai-yan , Ge Xiao-qin , Hua Ling-yan , Wang Xue-qin , Su Jian-bin 

TITLE=The Positive Relationship Between the Low-Density Lipoprotein Cholesterol/Apoprotein B Ratio and Bone Turnover Markers in Patients With Type 2 Diabetes

JOURNAL=Frontiers in Endocrinology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.903336

DOI=10.3389/fendo.2022.903336

ISSN=1664-2392

ABSTRACT=<sec><title>Background</title><p>Dyslipidemia may contribute to low bone turnover in patients with type 2 diabetes (T2D) through mediating oxidative stress and atherosclerosis. The low-density lipoprotein cholesterol/apoprotein B (LDL-C/Apo B) ratio is a surrogate marker of small and density low-density lipoprotein cholesterol (sd-LDL-C), a most harmful group of LDL-Cs. The present study aimed to investigate the association between the LDL-C/Apo B ratio and bone turnover in patients with T2D.</p></sec><sec><title>Methods</title><p>This study was a cross-sectional study enrolled patients with T2D from January 2021 to December 2021. Each participant was assessed for lipid profiles, bone turnover markers (BTMs), lumbar spine (L1-L4) and hip dual-energy X-ray absorptiometry (DXA) scans. Osteoporosis was diagnosed as a T-score lower than or equal to -2.5 at the spine or hip.</p></sec><sec><title>Results</title><p>A total of 335 patients with T2D were enrolled in the study, and the LDL-C/Apo B ratio ranged from 0.78 to 4.00. Along with the LDL-C/Apo B ratio tertile ascending, osteocalcin (OC), C-terminal telopeptide (CTx) and N-terminal propeptide of type-I procollagen (PINP) levels gradually increased (all <italic>p &lt;</italic> 0.05). There were no differences in lumbar spine and hip T-score, proportion of osteoporosis (all p &gt; 0.05) among the three subgroups. The LDL-C/Apo B ratio was positively correlated with lnOC (<italic>r =</italic> 0.244, <italic>p &lt;</italic> 0.001), lnCTx (<italic>r =</italic> 0.226, <italic>p &lt;</italic> 0.01) and lnPINP (<italic>r =</italic> 0.211, <italic>p &lt;</italic> 0.001). These significant positive correlations persisted even when divided into male and female subgroups. Furthermore, three multiple linear regression analyses were constructed to investigate the independent association of the LDL-C/Apo B ratio with the BTMs levels. After adjusting for other clinical parameters, the LDL-C/Apo B ratio was still significantly associated with OC level (<italic>β</italic> = 0.199, <italic>t</italic> = 3.348, <italic>p</italic> &lt; 0.01), CTx level (<italic>β</italic> = 0.238, <italic>t</italic> = 4.084, <italic>p</italic> &lt; 0.001) and PINP level (<italic>β</italic> = 0.162, <italic>t</italic> = 2.741, <italic>p</italic> &lt; 0.01).</p></sec><sec><title>Conclusion</title><p>The LDL-C/Apo B ratio was significantly and positively associated with BTMs in patients with T2D. In clinical practice, more attention should be paid to the patients with T2D whose LDL-C/Apo B ratio is relatively low for the purpose of maintaining bone health.</p></sec>