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Background <p>The lymphocyte to high-density lipoprotein ratio (LHR), a clinically novel marker, may more accurately represent inflammatory levels and body immunity compared to single parameters. However, there is not sufficient evidence that LHR and total bone mineral density (BMD) in teenagers are related.</p> Methods <p>The data utilized in this cross-sectional study derived from the National Health and Nutrition Examination Survey (NHANES), which ran from 2011 to 2018. To calculate the LHR, the lymphocyte count was divided by the HDL level. An investigation on the relationship between LHR and BMD was conducted using a linear regression analysis. Three distinct analytical scenarios employing multivariate logistic regression were implemented to evaluate the independent association between LHR activity and BMD. A stratified regression analysis was used to further examine them. In addition, threshold analysis was used to determine the inflection point.</p> Results <p>Among 6,068 adolescents (mean age 13.18 ± 2.73 years), a significant negative association was observed. In the fully adjusted model (controlling for demographics, socioeconomic status, lifestyle, and comorbidities), each unit increase in LHR was associated with a 0.02 g/cm<sup>2</sup> decrease in total BMD (β = -0.02, 95% CI -0.03 to -0.01). Threshold analysis revealed an L-shaped relationship, with a significant negative association evident only when LHR exceeded 1.26 (β = -0.02, 95% CI -0.03 to -0.01 for LHR &gt; 1.26).</p> Conclusions <p>In US children and adolescents, a higher LHR is independently associated with lower total BMD, exhibiting an L-shaped curve with a threshold effect at 1.26. These findings suggest that LHR may serve as a useful and accessible biomarker for assessing bone health risk in the young population. Further prospective studies are needed to elucidate the causal mechanisms underlying this association.</p>

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Association between lymphocyte to high-density lipoprotein ratio and total bone mineral density in 8–19-year-old children and adolescents: a cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月7日

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  • Wen Zujun,
  • Liu Xiang,
  • Zhang Tingting,
  • Lin Gengliang,
  • Zou Zhicong,
  • Jiang Shuncheng,
  • Yi Yanbin

摘要

Background

The lymphocyte to high-density lipoprotein ratio (LHR), a clinically novel marker, may more accurately represent inflammatory levels and body immunity compared to single parameters. However, there is not sufficient evidence that LHR and total bone mineral density (BMD) in teenagers are related.

Methods

The data utilized in this cross-sectional study derived from the National Health and Nutrition Examination Survey (NHANES), which ran from 2011 to 2018. To calculate the LHR, the lymphocyte count was divided by the HDL level. An investigation on the relationship between LHR and BMD was conducted using a linear regression analysis. Three distinct analytical scenarios employing multivariate logistic regression were implemented to evaluate the independent association between LHR activity and BMD. A stratified regression analysis was used to further examine them. In addition, threshold analysis was used to determine the inflection point.

Results

Among 6,068 adolescents (mean age 13.18 ± 2.73 years), a significant negative association was observed. In the fully adjusted model (controlling for demographics, socioeconomic status, lifestyle, and comorbidities), each unit increase in LHR was associated with a 0.02 g/cm2 decrease in total BMD (β = -0.02, 95% CI -0.03 to -0.01). Threshold analysis revealed an L-shaped relationship, with a significant negative association evident only when LHR exceeded 1.26 (β = -0.02, 95% CI -0.03 to -0.01 for LHR > 1.26).

Conclusions

In US children and adolescents, a higher LHR is independently associated with lower total BMD, exhibiting an L-shaped curve with a threshold effect at 1.26. These findings suggest that LHR may serve as a useful and accessible biomarker for assessing bone health risk in the young population. Further prospective studies are needed to elucidate the causal mechanisms underlying this association.