Fang Jia,1,* Yuting Lu,2,* Haotian Wen,3 Jun Tu,4– 6 Xianjia Ning,4– 6 Jinghua Wang,4– 6 Ping Li1 

1Department of Anesthesia, Tianjin Hospital, Tianjin, 300211, People’s Republic of China; 2School of Basic Medical Sciences, Tianjin Medical University, Tianjin, 300070, People’s Republic of China; 3The First Clinical School of Southern Medical University, Guangzhou, Guangdong Province, 510515, People’s Republic of China; 4Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 5Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China; 6Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ping Li, Department of Anesthesia, Tianjin Hospital, 406 Jiefang Road, Hexi District, Tianjin, 300211, People’s Republic of China, Tel +86-22-60913000, Fax +86-22-60910608, Email liping_tjh@163.com

Background: Osteoporosis (OP) is a major metabolic bone disease with significant health and socioeconomic impacts. The triglyceride-glucose (TyG) index and its derivatives, which reflect insulin resistance (IR), may play a role in bone metabolism. However, the relationship between TyG indices and OP is unclear. This study aimed to explore the association between TyG indices and OP in a low-income rural Chinese population.
Methods: This cross-sectional study was conducted in rural Tianjin, China, in 2020. Participants aged 60 years or older were included. Data were collected through interviews, including sociodemographic and clinical information, and physical examinations. Bone mineral density (BMD) of the femoral neck was measured using dual-energy X-ray absorptiometry (DXA). Multivariate regression models and restricted cubic spline (RCS) curves were used to assess the relationships between TyG indices and OP.
Results: A total of 437 individuals were included in the final analysis, with 38 diagnosed with osteoporosis (prevalence of 8.7%). After adjusting for all covariates, each 1-unit increase in triglyceride-glucose-body mass index (TyG-BMI) was associated with a 2% lower risk of osteoporosis, (OR: 0.98, 95% CI: 0.96– 1.00, P=0.029), especially in women, individuals with hypertension, and non-diabetic populations. The OP risk of the fourth quartile (Q4) of the triglyceride-glucose-waist circumference (TyG-WC) index after correcting for all covariates is 5.58 times that of the first quartile (Q1)(OR: 5.58, 95% CI: 1.14– 27.41, P=0.034). Linear regression showed a positive correlation between TyG-BMI and BMD, particularly in women, individuals under 70, and those with hypertension or non-hypertension, with the strongest correlation in the non-hypertensive group.
Conclusion: TyG-related indices are associated with OP, suggesting a potential role in the early prevention and management of osteoporosis in this population, ultimately improving public health outcomes.

Keywords: triglyceride glucose, triglyceride glucose-waist circumference, osteoporosis, bone mineral density, restricted cubic spline