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炎性标志物作为绝经后骨质疏松症的预测因子:来自苏丹卡布斯大学医院的横断面研究。

Inflammatory Markers as a Predictor of Postmenopausal Osteoporosis: Cross-sectional study from Sultan Qaboos University Hospital.

机构信息

Department of Family Medicine and Public Health, Sultan Qaboos University Hospital, Muscat, Oman.

Department of Family Medicine & Public Health, Ministry of Health, Muscat, Oman.

出版信息

Sultan Qaboos Univ Med J. 2022 Nov;22(4):508-514. doi: 10.18295/squmj.11.2021.145. Epub 2022 Nov 7.

Abstract

OBJECTIVES

Postmenopausal osteoporosis is a progressive metabolic bone disease resulting from oestrogen deficiency. Due to the silent nature of the disease, there is an urgent need for a simple, early predictive marker. This study aimed to assess the potential of three factors-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, from January 2017 to December 2019. The participants were allocated to groups based on lumbar spine BMD t-score values. A receiver operating characteristic curve was used to determine 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 among the groups. BMD t-score values were reversely correlated with age ( = 0.007) and PLR ( = 0.004) and positively correlated with body mass index (BMI; <0.001). The AUC was 0.59. The independent predictors of low BMD were age (>65 years) and BMI (<25 kg/m).

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.

摘要

目的

绝经后骨质疏松症是一种由雌激素缺乏引起的进行性代谢性骨病。由于该疾病的隐匿性,因此迫切需要一种简单、早期的预测标志物。本研究旨在评估三种炎症标志物(中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)和血小板与淋巴细胞比值(PLR))作为骨密度(BMD)丢失的潜在标志物。

方法

本回顾性横断面研究纳入了 2017 年 1 月至 2019 年 12 月在阿曼首都马斯喀特的苏丹卡布斯大学医院接受双能 X 射线吸收法检查的 450 例绝经后阿曼女性。根据腰椎 BMD t 评分值将参与者分配到不同的组。使用受试者工作特征曲线(ROC 曲线)确定曲线下面积(AUC)。采用多变量逻辑回归分析确定低 BMD 的独立预测因素。

结果

共有 65 例(14.4%)、164 例(36.4%)和 221 例(49.1%)女性分别被分配到对照组、骨量减少组和骨质疏松组。各组间 PLR、MLR 和 NLR 值无显著差异。BMD t 评分值与年龄呈负相关( = 0.007),与 PLR 呈负相关( = 0.004),与体重指数(BMI)呈正相关( <0.001)。AUC 为 0.59。低 BMD 的独立预测因素为年龄(>65 岁)和 BMI(<25 kg/m )。

结论

本研究中未发现三种炎症生物标志物中的任何一种可作为骨丢失的有用预后指标。建议进一步研究以排除或支持炎症状态在发病机制中的作用的理论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/155d/9645504/4929ac6f28c7/squmj2211-508-514f1.jpg

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