To explore the association between different complete blood count (CBC)-derived inflammation indices and the risk of osteoporotic fracture.
A retrospective analysis was performed based on clinical data from 3 560 patients hospitalized in the Department of Osteoporosis at West China Fourth Hospital, Sichuan University. Based on the presence or absence of osteoporotic fracture, the patients were classified into cases and controls. Binary logistic regression, restricted cubic splines, and subgroup analyses were employed to examine the associations of neutrophil / lymphocyte ratio (NLR), monocyte /lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), the product of platelet count and neutrophil count (PPN), systemic immune-inflammation index (SII), aggregate index of systemic inflammation (AISI) and systemic inflammatory response index (SIRI) with fracture. The performance of the model was evaluated using the receiver operating characteristic curve.
Levels of NLR, MLR, SII, AISI, and SIRI were higher in the case group compared to the control group (P<0.05). After adjusting for age, sex, BMI, bone density, diabetes, coronary heart disease, hypertension and C-reactive protein (CRP), PPN was negatively associated with osteoporotic fracture risk (OR=0.93, 95% CI: 0.86-1.00). Subgroup analysis revealed that the negative association between PPN and osteoporotic fracture was predominantly observed in women and non-diabetic patients. Among patients with diabetes, MLR (OR=1.47, 95% CI: 1.15-1.88), NLR (OR=1.24, 95% CI: 1.00-1.54), and SIRI (OR=1.37, 95% CI: 1.07-1.74) were significantly positively correlated with osteoporotic fracture risk. The incorporation of MLR, NLR, and SIRI into the traditional risk factor model significantly improved its discriminatory ability.
Elevated PPN levels are associated with a reduced fracture risk in patients with osteoporosis, suggesting that PPN may be a potential protective factor. Among patients with comorbid diabetes, NLR, MLR, and SIRI were significant risk factors and provided valuable incremental information, improving the discriminative ability of the model. This study suggests that CBC-derived inflammation indices can serve as a useful supplement for fracture risk assessment and assist in the early identification and stratification of high-risk populations.
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |