Table_1_Association of apolipoprotein A1 levels with lumbar bone mineral density and β-CTX in osteoporotic fracture individuals: a cross-sectional investigation.docx

BackgroundThe relationship between the levels of high-density lipoprotein (HDL) and bone mineral density (BMD) is controversial. Furthermore, the specific role of apolipoprotein A1 (APOA1), a primary HDL component, in regulating BMD remains unclear. This study aimed to elucidate the correlation between APOA1 levels and lumbar BMD in patients with osteoporotic fracture (OPF) for novel insights into potential therapeutic strategies against osteoporosis.
MethodsThis study included 587 OPF patients enrolled at the Kunshan Hospital, Affiliated with Jiangsu University between January 2017 and July 2022. The patient’s serum APOA1 levels were determined, followed by the assessment of lumbar BMD and C-terminal telopeptide of type I collagen (β-CTX) as outcome variables. The association of APOA1 levels with lumbar BMD and β-CTX was assessed via Generalized Estimating Equations (GEE) and spline smoothing plot analyses. A generalized additive model (GAM) helped ascertain non-linear correlations. Moreover, a subgroup analysis was also conducted to validate the result’s stability.
ResultsIt was observed that APOA1 levels were positively correlated with lumbar BMD (β = 0.07, 95% CI: 0.02 to 0.11, p = 0.0045), indicating that increased APOA1 levels were linked with enhanced lumbar BMD. Furthermore, APOA1 levels were negatively related to β-CTX (β = −0.19, 95% CI: −0.29 to −0.09, p = 0.0003), suggesting APOA1 might reduce osteolysis. In addition, these findings were robustly supported by subgroup and threshold effect analyses.
ConclusionThis study indicated that increased APOA1 levels were correlated with enhanced lumbar BMD and decreased osteolysis in OPF patients. Therefore, APOA1 may inhibit osteoclast activity to prevent further deterioration in osteoporotic patients. However, further research I warranted to validate these conclusions and elucidate the underlying physiologies.

背景 高密度脂蛋白（high-density lipoprotein, HDL）水平与骨密度（bone mineral density, BMD）之间的关联尚存争议。此外，高密度脂蛋白的主要组分载脂蛋白A1（apolipoprotein A1, APOA1）在调控骨密度中的具体作用仍不明确。本研究旨在阐明骨质疏松性骨折（osteoporotic fracture, OPF）患者体内APOA1水平与腰椎骨密度的相关性，为骨质疏松症的潜在治疗策略提供新见解。方法 本研究纳入2017年1月至2022年7月期间，江苏大学附属昆山医院收治的587例OPF患者。检测患者血清APOA1水平，并以腰椎骨密度及I型胶原C端肽（β-CTX）作为结局变量。通过广义估计方程（Generalized Estimating Equations, GEE）与样条平滑图分析，评估APOA1水平与腰椎骨密度、β-CTX的关联；借助广义加性模型（generalized additive model, GAM）明确二者的非线性相关关系。此外，本研究还开展了亚组分析以验证结果的稳定性。结果 研究观察到，APOA1水平与腰椎骨密度呈正相关（β=0.07，95%CI：0.02~0.11，p=0.0045），提示APOA1水平升高与腰椎骨密度增加存在关联。进一步分析显示，APOA1水平与β-CTX呈负相关（β=-0.19，95%CI：-0.29~-0.09，p=0.0003），表明APOA1或可减少骨溶解。亚组分析与阈值效应分析进一步证实了上述研究结果的稳健性。结论 本研究表明，OPF患者体内APOA1水平升高与腰椎骨密度增加、骨溶解减少显著相关。据此推测，APOA1可能通过抑制破骨细胞活性，延缓骨质疏松患者的病情恶化。但仍需开展进一步研究以验证上述结论，并阐明其潜在的生理学机制。