{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T19:04:20Z","timestamp":1780340660863,"version":"3.54.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"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. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Osteoporosis is a multifactorial bone disease in which lipid metabolism plays an important role. Bone Mineral Density (BMD) measured by Dual-energy X-ray Absorptiometry (DXA) is a critical indicator for diagnosing osteoporosis. The cardiometabolic index (CMI) is a novel metric that combines two quantitative indicators of blood lipids\u2014triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C). This study explores the association between CMI and BMD and seeks to elucidate the role of lipid metabolism in the context of bone health.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Based on the data of the National Health and Nutrition Examination Survey (NHANES) 2017\u2013March 2020-pre-pandemic, weighted multiple linear regression and smooth curve fitting were used to study the relationship between CMI and femoral BMD. Stratified analyses were also conducted for age, gender, BMI, ethnicity, diabetes and hypertension status. And, the saturation threshold effect of CMI was further analyzed using a two-stage linear regression model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>This study enrolled a total of 1,650 participants (48.7% males), with an average age of 63.0\u2009\u00b1\u20098.6\u2009years. After adjusting for multiple confounding factors, CMI was positively correlated with total femur BMD, trochanter BMD, and intertrochanter BMD, while the correlation with femur neck BMD was not statistically significant. In the fully adjusted model, each unit increase in CMI was associated with a 0.026 (g\/cm<jats:sup>2<\/jats:sup>) increase in total femur BMD, a 0.022 (g\/cm<jats:sup>2<\/jats:sup>) increase in trochanter BMD, and a 0.034 (g\/cm<jats:sup>2<\/jats:sup>) increase in intertrochanter BMD. Subjects in the highest quartile of CMI had a 0.034 (g\/cm<jats:sup>2<\/jats:sup>) increase in total femur BMD, a 0.035 (g\/cm<jats:sup>2<\/jats:sup>) increase in trochanter BMD, and a 0.039 (g\/cm<jats:sup>2<\/jats:sup>) increase in intertrochanter BMD in the fully-adjusted model compared to those in the lowest quartile. In addition, saturation was observed between CMI and total femur BMD, trochanter BMD and intertrochanter BMD, with saturation thresholds of 1.073, 1.431 and 1.073, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CMI is strongly associated with BMD, indicating its potential relevance in bone metabolism. However, the role of CMI in the context of bone health, especially regarding osteoporosis risk, requires further investigation in large-scale prospective studies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1403450","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T05:04:10Z","timestamp":1726635850000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Cardiometabolic index is associated with increased bone mineral density: a population-based cross-sectional study"],"prefix":"10.3389","volume":"12","author":[{"given":"Xujin","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xixin","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"She","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liubing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongtao","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1097\/00003086-200003000-00016","article-title":"Osteoporosis","volume":"372","author":"Lane","year":"2000","journal-title":"Clin Orthop Relat Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"7477","DOI":"10.3390\/jcm11247477","article-title":"Advancement in the treatment of osteoporosis and the effects on bone healing","volume":"11","author":"Kushchayeva","year":"2022","journal-title":"J Clin Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1979","DOI":"10.1007\/s00198-017-3996-1","article-title":"Trends in osteoporosis and low bone mass in older US adults, 2005\u20132006 through 2013\u20132014","volume":"28","author":"Looker ACI","year":"2017","journal-title":"Osteoporos Int"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s00198-018-4704-5","article-title":"Scientific advisory Board of the European Society for C, economic aspects of O, the committees of scientific a, National Societies of the international osteoporosis F: European guidance for the diagnosis and management of osteoporosis in postmenopausal women","volume":"30","author":"Kanis","year":"2019","journal-title":"Osteoporos Int"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"818","DOI":"10.7326\/M15-1361","article-title":"Clinical guidelines Committee of the American College of P, Barry MJ, Cooke M, Fitterman N, Harris RP, Humphrey LL et al: treatment of low bone density or osteoporosis to prevent fractures in men and women: a clinical practice guideline update from the American College of Physicians","volume":"166","author":"Qaseem","year":"2017","journal-title":"Ann Intern Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"115163","DOI":"10.1016\/j.bone.2019.115163","article-title":"Age at attainment of peak bone mineral density and its associated factors: the National Health and nutrition examination survey 2005\u20132014","volume":"131","author":"Xue","year":"2020","journal-title":"Bone"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1056\/NEJMcp1513724","article-title":"Clinical Practice. 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