{
  "abstract": "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. Results: Among 6389 participants, 1069 had total-body low bone mass. Total-body low bone mass showed more evident associations with lipid-related markers than central-site low bone mass. Each 10 mg/dL increase in HDL-C was associated with higher odds of total-body low bone mass (adjusted odds ratio [OR] = 1.080, 95% confidence interval [CI]: 1.018–1.147, p = 0.011). Although the linear association between TC/HDL-C and low bone mass was not statistically significant, spline analysis revealed a significant nonlinear association with total-body low bone mass, with a turning point at 4.39 (p for nonlinearity = 0.016). Exploratory analyses suggested effect modification by age and age-based grouping. Conclusions: Total-body low bone mass showed more evident associations with lipid indicators than central-site low bone mass. HDL-C was linearly associated with low bone mass, whereas TC/HDL-C showed an exploratory nonlinear association, supporting its potential role as a readily available metabolic correlate of skeletal status.",
  "abstract_shown": true,
  "affiliations": [
    "Department of General Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 333423, Taiwan",
    "School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan",
    "School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 110301, Taiwan",
    "Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan",
    "School of Public Health, College of Public Health, Taipei Medical University, Taipei 110301, Taiwan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Hung-Shuo Ko"
    },
    {
      "affs": [
        2
      ],
      "name": "Chiao-Wei Chang"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Chyi-Huey Bai",
      "orcid": "0000-0002-4658-1088"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3hkskdn3d5t2j.bib",
  "cited_by": 0,
  "doi": "10.3390/nu18203349",
  "fulltext_url": "https://europepmc.org/articles/PMC13708668",
  "id": "3hkskdn3d5t2j",
  "issns": [
    "2072-6643"
  ],
  "landing_url": "https://www.mdpi.com/2072-6643/18/20/3349",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2732|Bone health and osteoporosis research"
    ]
  ],
  "openalex": "W7221648234",
  "pdf_url": "https://europepmc.org/articles/PMC13708668?pdf=render",
  "pmcid": "PMC13708668",
  "pmid": "42942920",
  "published": "2026-10-13",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/3hkskdn3d5t2j.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:56Z",
      "native_id": "10.3390/nu18203349",
      "source": "crossref",
      "url": "https://www.mdpi.com/2072-6643/18/20/3349"
    },
    {
      "first_seen": "2026-10-30T12:22:12Z",
      "native_id": "MED:42942920",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42942920"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Bone health and osteoporosis research",
      "subfield": "surgery"
    }
  ],
  "title": "Lipid Indicators and Low Bone Mass Among Taiwanese Adults: A Cross-Sectional Association Study",
  "title_text": "Lipid Indicators and Low Bone Mass Among Taiwanese Adults: A Cross-Sectional Association Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:12Z",
  "url": "https://research.draconitic.com/paper/3hkskdn3d5t2j",
  "venue": "Nutrients",
  "versions": []
}