AUTHOR=Wang Wei , Chen Zhe Yuan , Lv Fen Yan , Tu Mei , Guo Xiu Li 

TITLE=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

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1182866

DOI=10.3389/fmed.2023.1182866

ISSN=2296-858X

ABSTRACT=<sec><title>Objective</title><p>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).</p></sec><sec><title>Method</title><p>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.</p></sec><sec><title>Results</title><p>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 <italic>T</italic>-score across the APOA1 tertiles. APOA1 presented a positive correlation with OC (<italic>r</italic> = 0.194, <italic>p</italic> &lt; 0.001), L1-L4 BMD (<italic>r</italic> = 0.165, <italic>p</italic> &lt; 0.001), and <italic>T</italic>-score (<italic>r</italic> = 0.153, <italic>p</italic> &lt; 0.001) rather than HDL-c. Meanwhile, APOA1 remained independently associated with OC (<italic>β</italic> = 0.126, <italic>p</italic> &lt; 0.001), L1-L4 BMD (<italic>β</italic> = 0.181, <italic>p</italic> &lt; 0.001), and <italic>T</italic>-score (<italic>β</italic> = 0.180, <italic>p</italic> &lt; 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%).</p></sec><sec><title>Conclusion</title><p>APOA1 is independently associated with OC, L1-L4 BMD, and osteoporosis rather than HDL-c in Chinese postmenopausal women with T2DM.</p></sec>