Association Between Serum Hemoglobin Level and Bone Mineral Density in Adults: Iranian Multi-Center Osteoporosis Study (Imos) Publisher Pubmed



Khadembashiri MA^{1, 2} ; Mohseni S² ; Aghakhani A¹ ; Khalagi K^{1, 3} ; Mansourzadeh MJ¹ ; Pejman Sani M² ; Mohajeritehrani M² ; Farzadfar F⁴ ; Fahimfar N^{1, 4} ; Ostovar A^{1, 4} Show Affiliations
Source: Archives of Osteoporosis Published:2025

Abstract

Summary: The associations between serum hemoglobin (Hb) levels and bone mineral density (BMD) were investigated in population of the 4th Iranian Multicenter Osteoporosis Study (IMOS). A positive relationship between Hb levels and BMD at hip and femoral neck were detected only in men. Purpose: Previous studies have investigated the relationship between hemoglobin (Hb) levels and bone mineral density (BMD) with controversial findings. This study aimed to evaluate this association using data from the 4th Iranian Multicenter Osteoporosis Study (IMOS), a population-based national survey, including a population sample aged 50 years and older. Methods: The present study was conducted as a cross-sectional data analysis derived from the fourth round of the IMOS. Demographic information, Hb levels, and BMD measurements were collected. BMD was measured with dual-energy X-ray absorptiometry (DXA). Low BMD (osteopenia/osteoporosis) and osteoporosis were defined as a T-score less than -1 and less than -2.5 at each site including hip, femoral neck, or lumbar spine, respectively. Multiple linear regression analysis was used to assess the relationship between Hb levels and BMD. Results: This study included 1,426 participants (54.2% female) with the mean age of 62.6 ± 8.0 years. The mean Hb levels among patients with or without osteoporosis were 12.9 ± 2.0 mg/dl and 13.1 ± 1.9 mg/dl, respectively (p-value = 0.08). It was demonstrated a positive relationship between Hb levels and BMD at hip (β = 0.0079, 95% CI: 0.002- 0.0135, p-value = 0.006) and femoral neck (β = 0.0064, 95% CI: 0.0015- 0.0113, p-value = 0.01) in only men. However, there was no significant correlation between Hb levels with low BMD and osteoporosis in either gender. Conclusion: Our findings showed a favorable relationship between Hb levels and BMD at the hip and femoral neck, particularly in men. This highlights gender and site-specific distinctions between hematological and skeletal health.Future studies should unravel these possible associations and investigate the underlying mechanisms. © International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation 2025.