Inflammatory Markers as a Predictor of Postmenopausal Osteoporosis

Abstract

Objectives: Postmenopausal osteoporosis is a progressive metabolic bone disease resulting from estrogen deficiency. However, due to the silent nature of the disease, there is an urgent need for a simple, early predictive marker. This study, conducted between January 2017 to December 2019, aimed to assess the potential of three factors—specifically, the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR)—as inflammatory markers of bone mineral density (BMD) loss. Methods: A retrospective cross-sectional study was conducted among 450 postmenopausal Omani women undergoing dual-energy X-ray absorptiometry at the Sultan Qaboos University Hospital, Muscat, Oman. Participants were allocated into groups based on lumbar spine BMD t-score values. A receiver-operating characteristic curve was used to find the area under the curve (AUC). Multivariate logistic regression was performed to identify independent predictors of low BMD. Results: A total of 65 (14.4%), 164 (36.4%), and 221 (49.1%) women were allocated to the control, osteopenia, and osteoporosis groups, respectively. No significant differences in PLR, MLR, and NLR values were observed based on group allocation. BMD t-score values were reversely correlated with age (P = 0.007) and PLR (P = 0.004), and positively correlated with body mass index (BMI) (P <0.001). The AUC was 0.59. However, the only independent predictors of low BMD were age (>65 years) and BMI (<25 kg/m2). Conclusion: None of the three inflammatory biomarkers studied were found to be useful prognostic indicators of bone loss. Further research is recommended to reject or support theories regarding the role of inflammatory status in the pathogenesis. Keywords: inflammatory markers, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, Bone mineral density, osteoporosis