Abstract
BACKGROUND: Triglycerides (TGs) are the major lipids in the human body and have an impact on bone development. However, evidence on the relationship between TG and bone mineral density (BMD) in pediatric populations remains sparse. This study systematically addresses this epidemiologic knowledge gap through a rigorous analysis of nationally representative data from the National Health and Nutrition Examination Survey (NHANES). METHOD: The present study examined a total of 3818 participants from NHANES spanning the years 2011 to 2018. The independent variable examined in this study was TG levels, while the dependent variable measured was BMD. The covariates were selected based on previous studies and clinical practice and included demographic information, laboratory testing, and pertinent physical examinations. The intrinsic association between TG and BMD was analyzed using weighted multiple linear regression and meticulous subgroup assessment. The smooth curve fitting visually demonstrates the linear correlation between them. RESULTS: The study ultimately included a total of 3,818 participants, consisting of 2,056 men and 1,762 women. After adjusting for all covariates, the weighted multiple linear regression model revealed a significant positive association between TG and pelvic BMD (β = 0.047, 95% CI: 0.032-0.062, P < 0.001). TG levels also exhibited a positive correlation with trunk BMD (β = 0.015, 95% CI: 0.006-0.025, P = 0.002). A correlation between pelvic BMD was observed only in the third and fourth quartiles of TG levels among the groups. After adjusting for all variables, TG demonstrated a significant positive association with lumbar BMD at the Q3 level (0.869-1.276) (β = 0.006, 95% CI: -0.007-0.018, P < 0.05). The findings indicated a lack of a statistically significant association between TG level and head BMD (P > 0.05). CONCLUSIONS: The impact of TG levels on BMD in the population of children and adolescents in the United States exhibits concentration-dependent variations and site-specific effects. It is recommended that children with low TG concentrations undergo regular testing for BMD. More research is required to further investigate the dual effects of TG on BMD and identify the optimal serum TG concentration for promoting bone development.