Association between hemoglobin glycation index and low bone mineral density in postmenopausal women: An analysis of data from the NHANES database

The hemoglobin glycation index (HGI), a valuable indicator reflecting individual variations in glycosylated hemoglobin (HbA1c), serves as a crucial measure of glucose metabolism, which may influence bone health. This study aimed to elucidate the association between HGI and low bone mineral density (BMD) in postmenopausal women. Utilizing data from the National Health and Nutrition Examination Survey database across the years 2005 to 2010, 2013 to 2014, and 2017 to 2018, we defined low BMD as a T-score ≤ -1.0 and employed logistic regression models to investigate the HGI-BMD relationship, further stratifying the analysis based on dietary antioxidant quality score (DAQS) classifications. From 1961 postmenopausal women included in our analysis, 1197 (60.56%) exhibited low BMD, with results indicating that women with HGI ≥ -0.0835 had elevated odds of low BMD (odds ratio [OR] = 1.47, 95% confidence interval [CI]: 1.09-1.98) compared to their counterparts with HGI < -0.0835. Notably, this association manifested significantly in participants with DAQSs <5 (OR = 1.44, 95% CI: 1.00-2.07, P = .049) while remaining absent among those with higher DAQSs. Subgroup analyses revealed that the increased odds of low BMD were predominant in women aged ≥65 years (OR = 1.80, 95% CI: 1.29-2.52) and those without a history of fractures (OR = 1.57, 95% CI: 1.16-2.13). Consequently, our findings endorse the hypothesis that elevated HGI correlates with a greater risk of low BMD in postmenopausal women, a relationship potentially modulated by dietary antioxidant intake, highlighting the need for further exploration of interventions targeting metabolic pathways influencing bone density.