血小板计数与血清高密度脂蛋白胆固醇含量比值与腰椎骨密度的关系研究OA

Objective:To investigate the relationship of platelet to high-density lipoprotein cholesterol ratio(PHR)with lumbar spine bone mineral density(BMD).Methods:Eleven thousand and five participants from National Health and Nutrition Examination Survey(NHANES)database between 2011 and 2018 were included in the study.The PHR of the participants was calculated,and then the included participants were categorized into 4 groups according to the quartiles of PHR,the population characteristics of the 4 groups were compared.After that,the association between PHR and lumbar spine BMD were examined by regression analyses,and the subgroup analyses were con-ducted,respectively,based on gender,age,whether combined with hypertension,whether combined with diabetes mellitus,and body mass index(BMI).For factors showing significant interaction effects with PHR in the subgroup analyses,the non-linear relationships were further explored.Results:①Grouping.The participants' PHR quartile thresholds were 3.690,4.750,and 6.080,respectively.The 11 005 partici-pants were categorized into Q1 group,Q2 group,Q3 group,and Q4 group,with 2751 ones in Q1 group(PHR≤3.690),4500 ones in Q2 group(3.690＜PHR ≤4.750),2500 ones in Q3 group(4.750＜PHR ≤6.080),and 1254 ones in Q4 group(PHR＞6.080).②Population characteristics among participants with different PHR.Significant differences were observed among the 4 groups in age,gender,education level,family income-to-poverty ratio,smoking,combined with hypertension,combined with diabetes mellitus,BMI,and lumbar spine BMD,as well as serum levels of glycated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),blood urea nitrogen(BUN),and uric acid(H=13.453,P=0.025;x2=12.081,P=0.042;x2=17.181,P=0.001;H=2.741,P=0.000;x2=16.246,P=0.002;x2=17.181,P=0.000;x2=15.245,P=0.001;F=2.471,P=0.001;F=0.627,P=0.000;H=6.245,P=0.020;F=14.588,P=0.030;F=17.245,P=0.001;F=12.235,P=0.000;H=4.257,P=0.040;F=4.256,P=0.023).③As-sociation between PHR and lumbar spine BMD.Both linear and logistic regression analyses revealed a significant inverse nonlinear relation-ship between PHR and lumbar BMD,and this inverse relationship between PHR and lumbar BMD was observed in the subgroups including male,female,participants aged 20 to＜29 years,29 to＜39 years,49 to＜59 years,those without hypertension or diabetes mellitus,and those with BMI 18.5 to＜25 kg/m(2)or25 to＜30 kg/m(2).Moreover,the PHR showed no significant interaction effects with the factors such as gender,age,whether combined with hypertension,or whether combined with diabetes mellitus(P=0.505,P=0.103,P=0.437,P=0.337),but a significant interaction effect with BMI(P=0.049).Furthermore,the piecewise linear regression analysis identified a threshold point in the relationship between PHR and lumbar BMD in the subgroup of participants with a BMI ≥ 30 kg/m(2)(PHR=5.806).When the PHR was ≤5.806,a significant inverse linear association was observed between PHR and lumbar BMD(β=-0.009,95％CI(-0.014,-0.004),P=0.000);in contrast,when the PHR was＞5.806,the association between PHR and lumbar BMD was not statistically significant(β=0.003,95％CI(-0.001,0.005),P=0.230).Conclusion:PHR exhibits an inverse nonlinear association with lumbar BMD,however,this association exhibits a threshold effect among the obese individuals:at PHR≤5.806,the PHR demonstrates an inverse linear relationship with lumbar BMD;while,at PHR＞5.806,no significant association exists between the both.