Novel association between atherogenic index of plasma and bone mineral density in men: a retrospective analysis

BACKGROUND: This study aimed to investigate the association between the atherogenic index of plasma (AIP), lipid parameters, and bone mineral density (BMD) in men with osteoporosis. METHODS: This retrospective, single-center study included 430 male patients aged ≥ 50 years admitted to the First Hospital of Shanxi Medical University between June 2022 and December 2024. Routine blood lipid profiles, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL) were collected. AIP was calculated as log10(TG/HDL). BMD was measured using dual-energy X-ray absorptiometry (DXA) and patients were categorized into normal (NO), osteopenia (ON), and osteoporosis (OP) groups. Correlation analysis, principal component analysis (PCA), and one-way Analysis of Variance (ANOVA) were applied. RESULTS: Among 430 participants, 218 were classified as NO, 133 as ON, and 79 as OP. PCA revealed that the first two components (PC1 eigenvalue = 2.127, PC2 eigenvalue = 1.531) explained 73.15% of the total variance (PC1: 42.53%, PC2: 30.62%), with AIP and TC identified as major contributors to BMD variation. Correlation analysis showed that AIP (r = -0.26,p = 0.003), TG (r = -0.15,p = 0.047), and HDL (r = 0.34,p < 0.001) were significantly associated with BMD, while TC and LDL were not. ANOVA demonstrated significant group differences in AIP and HDL, particularly between the OP and NO groups. CONCLUSION: Elevated AIP and altered HDL levels are associated with reduced BMD in men, highlighting their potential role in the early identification and risk stratification of male osteoporosis.