Lipid Indicators and Low Bone Mass Among Taiwanese Adults: A Cross-Sectional Association Study

Background & Aims: This study investigated the associations of lipid indicators, particularly the total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C), with low bone mass in adults.

Methods

This cross-sectional study included 6389 participants aged ≥19 years from the Nutrition and Health Survey in Taiwan (2013–2020). Two study-defined low-bone-mass phenotypes were evaluated as research phenotypes rather than densitometric diagnoses: central-site low bone mass, defined as a T-score < −1.0 at either the lumbar spine (L1–L4) or the lower of the bilateral femoral neck T-scores, and total-body low bone mass, defined as a total-body T-score < −1.0. Multivariable logistic regression models and restricted cubic spline analysis were performed to examine associations of lipid indicators with low bone mass. Subgroup analyses by sex, age, and age-defined menopausal status were exploratory.