{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:30:50Z","timestamp":1788546650201,"version":"build-2803163510"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Dyslipidemia may contribute to low bone turnover in patients with type 2 diabetes (T2D) through mediating oxidative stress and atherosclerosis. The low-density lipoprotein cholesterol\/apoprotein B (LDL-C\/Apo B) ratio is a surrogate marker of small and density low-density lipoprotein cholesterol (sd-LDL-C), a most harmful group of LDL-Cs. The present study aimed to investigate the association between the LDL-C\/Apo B ratio and bone turnover in patients with T2D.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was a cross-sectional study enrolled patients with T2D from January 2021 to December 2021. Each participant was assessed for lipid profiles, bone turnover markers (BTMs), lumbar spine (L1-L4) and hip dual-energy X-ray absorptiometry (DXA) scans. Osteoporosis was diagnosed as a T-score lower than or equal to -2.5 at the spine or hip.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 335 patients with T2D were enrolled in the study, and the LDL-C\/Apo B ratio ranged from 0.78 to 4.00. Along with the LDL-C\/Apo B ratio tertile ascending, osteocalcin (OC), C-terminal telopeptide (CTx) and N-terminal propeptide of type-I procollagen (PINP) levels gradually increased (all <jats:italic>p &amp;lt;<\/jats:italic> 0.05). There were no differences in lumbar spine and hip T-score, proportion of osteoporosis (all p &amp;gt; 0.05) among the three subgroups. The LDL-C\/Apo B ratio was positively correlated with lnOC (<jats:italic>r =<\/jats:italic> 0.244, <jats:italic>p &amp;lt;<\/jats:italic> 0.001), lnCTx (<jats:italic>r =<\/jats:italic> 0.226, <jats:italic>p &amp;lt;<\/jats:italic> 0.01) and lnPINP (<jats:italic>r =<\/jats:italic> 0.211, <jats:italic>p &amp;lt;<\/jats:italic> 0.001). These significant positive correlations persisted even when divided into male and female subgroups. Furthermore, three multiple linear regression analyses were constructed to investigate the independent association of the LDL-C\/Apo B ratio with the\u00a0BTMs levels. After adjusting for other clinical parameters, the LDL-C\/Apo B ratio was still significantly associated with OC level (<jats:italic>\u03b2<\/jats:italic> = 0.199, <jats:italic>t<\/jats:italic> = 3.348, <jats:italic>p<\/jats:italic> &amp;lt; 0.01), CTx level (<jats:italic>\u03b2<\/jats:italic> = 0.238, <jats:italic>t<\/jats:italic> = 4.084, <jats:italic>p<\/jats:italic> &amp;lt; 0.001) and PINP level (<jats:italic>\u03b2<\/jats:italic> = 0.162, <jats:italic>t<\/jats:italic> = 2.741, <jats:italic>p<\/jats:italic> &amp;lt; 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The LDL-C\/Apo B ratio was significantly and positively associated with BTMs in patients with T2D. In clinical practice, more attention should be paid to the patients with T2D whose LDL-C\/Apo B ratio is relatively low for the purpose of maintaining bone health.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.903336","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T06:13:21Z","timestamp":1654755201000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Positive Relationship Between the Low-Density Lipoprotein Cholesterol\/Apoprotein B Ratio and Bone Turnover Markers in Patients With Type 2 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