Xue Yuan, Bao Weichao, Huang Wenying, Zou Xin, Guo Ying
School of Clinical Medicine, Shandong Second Medical University, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong Province, China.
Department of Endocrinology and Metabolic Diseases, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong Province, China.
Medicine (Baltimore). 2024 Dec 13;103(50):e40869. doi: 10.1097/MD.0000000000040869.
Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR) are newly discovered inflammatory markers in recent years. To explore the relationship between NLR, MLR, PLR, and bone mineral density (BMD), as well as osteoporosis (OP), in postmenopausal patients with type 2 diabetes mellitus (T2DM). 320 postmenopausal patients with T2DM who were admitted to the Department of Endocrinology and Metabolic Diseases of our hospital from January 2022 to January 2024 for treatment were included in this retrospective study. The patients were divided into 3 groups according to the BMD: normal bone mass group (n = 109), osteopenia group (n = 99), and OP group (n = 112). Clinical data and blood laboratory parameters were collected from the patients. The NLR, MLR, and PLR were calculated. Statistically significant differences were found in the comparison of NLR, MLR, and PLR among the 3 groups of patients (P < .001). The OP group had higher NLR, MLR, and PLR than the normal bone mass group and the osteopenia group. NLR, MLR, and PLR were negatively correlated with BMD at the lumbar spine (L1-L4), left femoral neck, and left hip, respectively. Analysis revealed that elevated levels of NLR and PLR were independent risk factors for OP in postmenopausal patients. The results of the receiver operating characteristic curve analysis indicated that the area under the curve (AUC) for NLR was higher than that of PLR. Combined use of NLR and PLR resulting in an improved AUC of 0.904. Neutrophils produce mediators such as interferon-gamma (IFN-γ), interleukin-6 (IL-6), interleukin-1 (IL-1), and receptor activator of nuclear factor kappa-B ligand (RANKL), which increase the number and activity of osteoclasts. Peripheral blood monocytes play a vital role in osteoclastogenesis as osteoclast precursors. The BMD of postmenopausal T2DM patients is negatively correlated with NLR, MLR, and PLR. NLR and PLR can both serve as predictive indicators for the occurrence of OP in postmenopausal T2DM patients.
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）、血小板与淋巴细胞比值（PLR）是近年来新发现的炎症标志物。为探讨绝经后2型糖尿病（T2DM）患者中NLR、MLR、PLR与骨密度（BMD）以及骨质疏松症（OP）之间的关系。本回顾性研究纳入了2022年1月至2024年1月期间因治疗入住我院内分泌与代谢疾病科的320例绝经后T2DM患者。根据骨密度将患者分为3组：骨量正常组（n = 109）、骨量减少组（n = 99）和骨质疏松组（n = 112）。收集患者的临床资料和血液实验室参数。计算NLR、MLR和PLR。在3组患者中比较NLR、MLR和PLR时发现有统计学显著差异（P <.001）。骨质疏松组的NLR、MLR和PLR高于骨量正常组和骨量减少组。NLR、MLR和PLR分别与腰椎（L1 - L4）、左股骨颈和左髋部的骨密度呈负相关。分析显示，NLR和PLR水平升高是绝经后患者发生骨质疏松症的独立危险因素。受试者工作特征曲线分析结果表明，NLR的曲线下面积（AUC）高于PLR。联合使用NLR和PLR可使AUC提高至0.904。中性粒细胞产生干扰素 - γ（IFN - γ）、白细胞介素 - 6（IL - 6）、白细胞介素 - 1（IL - 1）和核因子κB受体活化因子配体（RANKL）等介质，这些介质会增加破骨细胞的数量和活性。外周血单核细胞作为破骨细胞前体在破骨细胞形成过程中起重要作用。绝经后T2DM患者的骨密度与NLR、MLR和PLR呈负相关。NLR和PLR均可作为绝经后T2DM患者骨质疏松症发生的预测指标。
