Association between RBC folate and lumbar bone mineral density in postmenopausal women, a cross-sectional study from NHANES 2009–2018

BackgroundPostmenopausal women are at an increased risk of bone density reduction, with multiple factors implicated, including folate, a B vitamin whose impact on bone health is gaining attention. The purpose of this research was to examine the association between red blood cell (RBC) folate levels...

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Main Authors: Hua Wei, Ziqi Jin, Liangji Zhou, Gangjian Tang, Sheng Chai, Xiaoqiao Che, Yongxing Tan, Weiqing Zeng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1559043/full
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author Hua Wei
Ziqi Jin
Ziqi Jin
Liangji Zhou
Liangji Zhou
Gangjian Tang
Sheng Chai
Xiaoqiao Che
Yongxing Tan
Weiqing Zeng
author_facet Hua Wei
Ziqi Jin
Ziqi Jin
Liangji Zhou
Liangji Zhou
Gangjian Tang
Sheng Chai
Xiaoqiao Che
Yongxing Tan
Weiqing Zeng
author_sort Hua Wei
collection DOAJ
description BackgroundPostmenopausal women are at an increased risk of bone density reduction, with multiple factors implicated, including folate, a B vitamin whose impact on bone health is gaining attention. The purpose of this research was to examine the association between red blood cell (RBC) folate levels and lumbar bone mineral density (BMD) in postmenopausal women.MethodsWe performed a cross-sectional study to investigate the association between postmenopausal women’s lumbar BMD and RBC folate levels, using the data from the 2009–2018 National Health and Nutrition Examination Survey (NHANES). Participants were categorized into quartiles based on RBC folate levels (Q1-Q4). Univariate and multivariate regression models assessed the association between RBC folate levels and lumbar BMD, with threshold effect analysis performed.ResultsA total of 1315 postmenopausal women were included. RBC folate levels were positively associated with lumbar BMD. The trend analysis across the quartiles of RBC folate indicated a statistically significant trend in all models (P for trend: Model 1 = 0.020; Model 2 = 0.015; Model 3 = 0.037), suggesting that higher RBC folate levels are associated with increased lumbar BMD. In the unadjusted model 1, a 10 nmol/L increase in RBC folate was associated with a 0.0002 g/cm² increase in lumbar BMD (P=0.002509). The correlation was still significant (P=0.0006) even after age and race were taken into account (model 2). Further adjustment for multiple variables (model 3) showed a 0.0002 g/cm² increase in lumbar BMD per 10 nmol/L increase in RBC folate (P=0.0212). Threshold effect analysis revealed a breakpoint at 92.4 nmol/dL, suggesting a nonlinear relationship between RBC folate levels and lumbar BMD.ConclusionsPostmenopausal women’s RBC folate levels had a positive association with their lumbar BMD. Maintaining appropriate RBC folate levels may help preserve bone density and offer a fresh approach to avoiding osteoporosis in postmenopausal women.
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spelling doaj-art-a1513f391b2e451ebe9a3c3aeee50beb2025-08-20T02:20:00ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-04-011610.3389/fendo.2025.15590431559043Association between RBC folate and lumbar bone mineral density in postmenopausal women, a cross-sectional study from NHANES 2009–2018Hua Wei0Ziqi Jin1Ziqi Jin2Liangji Zhou3Liangji Zhou4Gangjian Tang5Sheng Chai6Xiaoqiao Che7Yongxing Tan8Weiqing Zeng9Department of Orthopedics, Guilin Municipal Hospital of Traditional Chinese Medicine, Guilin, Guangxi, ChinaDepartment of Orthopedics, Guilin Municipal Hospital of Traditional Chinese Medicine, Guilin, Guangxi, ChinaGraduate College, Guangxi University of Chinese Medicine, Nanning, Guangxi, ChinaDepartment of Orthopedics, Guilin Municipal Hospital of Traditional Chinese Medicine, Guilin, Guangxi, ChinaGraduate College, Guangxi University of Chinese Medicine, Nanning, Guangxi, ChinaDepartment of Orthopedics, Guilin Municipal Hospital of Traditional Chinese Medicine, Guilin, Guangxi, ChinaDepartment of Orthopedics, Guilin Municipal Hospital of Traditional Chinese Medicine, Guilin, Guangxi, ChinaDepartment of Orthopedics, Guilin Municipal Hospital of Traditional Chinese Medicine, Guilin, Guangxi, ChinaDepartment of Orthopedics, Guilin Municipal Hospital of Traditional Chinese Medicine, Guilin, Guangxi, ChinaDepartment of Orthopedics, Guilin Municipal Hospital of Traditional Chinese Medicine, Guilin, Guangxi, ChinaBackgroundPostmenopausal women are at an increased risk of bone density reduction, with multiple factors implicated, including folate, a B vitamin whose impact on bone health is gaining attention. The purpose of this research was to examine the association between red blood cell (RBC) folate levels and lumbar bone mineral density (BMD) in postmenopausal women.MethodsWe performed a cross-sectional study to investigate the association between postmenopausal women’s lumbar BMD and RBC folate levels, using the data from the 2009–2018 National Health and Nutrition Examination Survey (NHANES). Participants were categorized into quartiles based on RBC folate levels (Q1-Q4). Univariate and multivariate regression models assessed the association between RBC folate levels and lumbar BMD, with threshold effect analysis performed.ResultsA total of 1315 postmenopausal women were included. RBC folate levels were positively associated with lumbar BMD. The trend analysis across the quartiles of RBC folate indicated a statistically significant trend in all models (P for trend: Model 1 = 0.020; Model 2 = 0.015; Model 3 = 0.037), suggesting that higher RBC folate levels are associated with increased lumbar BMD. In the unadjusted model 1, a 10 nmol/L increase in RBC folate was associated with a 0.0002 g/cm² increase in lumbar BMD (P=0.002509). The correlation was still significant (P=0.0006) even after age and race were taken into account (model 2). Further adjustment for multiple variables (model 3) showed a 0.0002 g/cm² increase in lumbar BMD per 10 nmol/L increase in RBC folate (P=0.0212). Threshold effect analysis revealed a breakpoint at 92.4 nmol/dL, suggesting a nonlinear relationship between RBC folate levels and lumbar BMD.ConclusionsPostmenopausal women’s RBC folate levels had a positive association with their lumbar BMD. Maintaining appropriate RBC folate levels may help preserve bone density and offer a fresh approach to avoiding osteoporosis in postmenopausal women.https://www.frontiersin.org/articles/10.3389/fendo.2025.1559043/fulllumbar BMDRBC folateosteoporosispostmenopausal femalea cross-sectional studyNHANES
spellingShingle Hua Wei
Ziqi Jin
Ziqi Jin
Liangji Zhou
Liangji Zhou
Gangjian Tang
Sheng Chai
Xiaoqiao Che
Yongxing Tan
Weiqing Zeng
Association between RBC folate and lumbar bone mineral density in postmenopausal women, a cross-sectional study from NHANES 2009–2018
Frontiers in Endocrinology
lumbar BMD
RBC folate
osteoporosis
postmenopausal female
a cross-sectional study
NHANES
title Association between RBC folate and lumbar bone mineral density in postmenopausal women, a cross-sectional study from NHANES 2009–2018
title_full Association between RBC folate and lumbar bone mineral density in postmenopausal women, a cross-sectional study from NHANES 2009–2018
title_fullStr Association between RBC folate and lumbar bone mineral density in postmenopausal women, a cross-sectional study from NHANES 2009–2018
title_full_unstemmed Association between RBC folate and lumbar bone mineral density in postmenopausal women, a cross-sectional study from NHANES 2009–2018
title_short Association between RBC folate and lumbar bone mineral density in postmenopausal women, a cross-sectional study from NHANES 2009–2018
title_sort association between rbc folate and lumbar bone mineral density in postmenopausal women a cross sectional study from nhanes 2009 2018
topic lumbar BMD
RBC folate
osteoporosis
postmenopausal female
a cross-sectional study
NHANES
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1559043/full
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