Association of platelet count with P1NP level in patients with osteoporotic fractures: a retrospective cross- sectional study

Abstract

Abstract Platelets play a crucial part in bone remodeling and may regulate bone formation by releasing cytokines. Pre-collagen type 1 N-terminal peptide (P1NP) is a key biomarker that indicates new bone formation. However, the association between platelet count and P1NP level in patients with osteoporotic (OP) fractures remains unclear.This retrospective cross-sectional study analyzed data from 752 OP fracture patients hospitalized between January 2015 and March 2022. Serum P1NP concentration serve as the dependent variable, while platelet count was used as the exposure variable. Covariates included age, gender; Charlson comorbidity index (CCI), body mass index (BMI), lymphocyte (Lym), neutrophil (Neu), monocyte (Mono). Independent associations between platelet count and P1NP level were assessed by employing generalized estimating equations after adjusting for covariates. Non-linear relationships were detected with the help of generalized additive models. The present study found a positive association between platelet count and P1NP level in patients with OP fractures (β = 0.05; 95% CI [confident interval] = 0.02 to 0.08; P = 0.0011). This association remained significant after multivariate adjustment. Moreover, the nonlinear model showed a threshold effect, with platelet count above 220.5 (109/L) being positively correlated with P1NP (β = 0.13; 95% CI = 0.06 to 0.21; P = 0.0004). However, this correlation did not hold true for platelet count below 220.5 (109/L) (β = 0.01; 95% CI = -0.05 to 0.08; P = 0.67). The present work demonstrates an independent positive association between platelet count and P1NP level in osteoporotic fracture patients. This study also revealed a nonlinear association and a threshold effect between platelet count and P1NP level. Platelet count may be indicative of new bone formation, providing a basis for fracture risk assessment. Further research is warranted to validate these results.