Association between low-carbohydrate-diet score and osteoporosis in hypertensive patients: a cross-sectional study

BACKGROUND: The low-carbohydrate diet (LCD) score reflects the relative intake of carbohydrates, protein, and fat. However, the association between LCD score and osteoporosis (OP) in hypertensive adults remains unclear. SUBJECTS AND METHODS: This cross-sectional study included hypertensive adults from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. The LCD score was calculated based on participants' dietary intake. Logistic regression analysis was performed to evaluate the association between LCD score and OP. Restricted cubic spline (RCS) analysis was used to explore the dose-response relationship, and subgroup analyses were conducted to assess potential effect modification. RESULTS: A total of 7,493 hypertensive adults were included in the study. After adjustment for covariates, each one-unit increase in LCD score was associated with a 2.1% lower odds of OP (OR = 0.979, 95% CI = 0.960-0.999). Compared with participants in the lowest quartile of LCD score, those in the highest quartile had significantly lower odds of OP (OR = 0.571, 95% CI = 0.388-0.840). RCS analysis showed a significant linear inverse association between LCD score and OP. Subgroup analyses showed that physical activity significantly modified this association. CONCLUSION: Higher LCD scores were inversely associated with OP in hypertensive adults. These findings suggest a potential role of dietary patterns in bone health management in this population.