Serum lipid levels serve as predictors for osteoporosis or osteopenia in postmenopausal women: A meta-analysis of observational studies

Abstract

This meta-analysis summarizes the differences in serum lipid levels among postmenopausal women with osteopenia, osteoporosis, and normal bone mass, aiming to establish reliable lipid markers for predicting bone loss in postmenopausal women. Relevant literature published up to March 21, 2024, was sourced from databases including PubMed, Embase, Web of Science, and the Cochrane Library. Following a thorough evaluation in accordance with established inclusion and exclusion criteria, the meta-analysis incorporated 14 studies, involving a total of 12,974 postmenopausal women. The weighted mean deviation (WMD) and 95% confidence intervals (CIs) were conducted by RevMan 5.4 software. The findings indicated that serum triglyceride (TG) concentrations were significantly lower in osteopenia (WMD = -6.82, 95% CI: -9.80 to -3.83, P = 0.05, I² = 42%) and osteoporosis (WMD = -10.28, 95% CI: -14.51 to -6.04, P < 0.001, I² = 45%) women compared to their normal counterparts. In addition, serum high-density lipoprotein cholesterol (HDL-C) levels were notably elevated in osteoporosis women (WMD = 1.66, 95% CI: 0.75 to 2.57, P = 0.0004, I² = 43%). However, no significant discrepancies were found in total cholesterol and low-density lipoprotein cholesterol levels among postmenopausal women with bone loss. Sensitivity analysis showed that the results of the meta-analysis were reliable. Egger's test showed no publication bias in the included studies. Consequently, our meta-analysis shows that low serum TG levels predict the onset of osteopenia in postmenopausal women, while high serum HDL-C levels suggest a potential risk for osteoporosis.