Cedeno-Veloz Bernardo Abel, Rodriguez-Garcia Alba María, Zambom-Ferraresi Fabricio, Domínguez-Mendoza Soledad, Guruceaga-Eguillor Irene, Ruiz-Izquieta Virginia, Lasarte Juan Jose, Martinez-Velilla Nicolás
Navarre University Hospital (HUN), Navarrabiomed, Institute for Health Research of Navarra (IdiSNA), 31008 Pamplona, Spain.
Heath Sciences Department, Public University of Navarre, 31006 Pamplona, Spain.
Int J Mol Sci. 2025 Sep 19;26(18):9138. doi: 10.3390/ijms26189138.
Inflammaging has been implicated in age-related bone loss and fragility fractures through immune-mediated effects on bone turnover. We aimed to explore the relationship between systemic inflammatory markers and bone health in older adults, focusing on the differences between patients with osteoporotic fractures and non-fractured controls. We retrospectively analyzed 40 older patients (20 with hip fractures and 20 with osteoarthritis without prior fragility fractures). We compared routine inflammatory markers, including red cell distribution width (RDW), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and the composite CRP-albumin-lymphocyte index (CALLY), between groups. Bone mineral density (BMD) at the hip, lumbar spine, and wrist, as well as the FRAX score, were assessed. Correlations between inflammatory markers, BMD, and FRAX scores were evaluated using Spearman's coefficient. Patients with fractures exhibited significantly elevated CRP (66.2 ± 70.3 vs. 3.8 ± 4.0 mg/L, = 0.0008) and SII (1399.7 ± 1143.4 vs. 751.4 ± 400.8, = 0.025) compared to controls. RDW, NLR, and CALLY scores did not differ significantly between the groups. Higher CRP levels were associated with lower BMD at all sites (hip: r ≈ -0.63, = 0.002; spine: r ≈ -0.60, = 0.005; wrist: r ≈ -0.60, = 0.005). No significant correlations were observed between the SII and BMD or FRAX values. Elevated systemic inflammation, particularly indicated by CRP and SII, was associated with osteoporotic fracture status and low bone density in our cohort. These findings support the concept that inflammatory pathways may contribute to osteoporosis and fracture risk and suggest that inflammatory markers could serve as adjunctive tools in fracture risk assessment. Further studies are required to clarify the causality and evaluate whether targeting chronic inflammation can improve bone health in older adults.
炎症衰老通过对骨转换的免疫介导作用，与年龄相关的骨质流失和脆性骨折有关。我们旨在探讨老年人全身炎症标志物与骨骼健康之间的关系，重点关注骨质疏松性骨折患者与未骨折对照组之间的差异。我们回顾性分析了40例老年患者（20例髋部骨折患者和20例无既往脆性骨折的骨关节炎患者）。我们比较了两组之间的常规炎症标志物，包括红细胞分布宽度（RDW）、C反应蛋白（CRP）、中性粒细胞与淋巴细胞比值（NLR）、全身免疫炎症指数（SII）以及复合CRP-白蛋白-淋巴细胞指数（CALLY）。评估了髋部、腰椎和腕部的骨密度（BMD）以及FRAX评分。使用Spearman系数评估炎症标志物、BMD和FRAX评分之间的相关性。与对照组相比，骨折患者的CRP（66.2±70.3 vs. 3.8±4.0 mg/L，P = 0.0008）和SII（1399.7±1143.4 vs. 751.4±400.8，P = 0.025）显著升高。两组之间的RDW、NLR和CALLY评分无显著差异。较高的CRP水平与所有部位较低的BMD相关（髋部：r≈-0.63，P = 0.002；脊柱：r≈-0.60，P = 0.005；腕部：r≈-0.60，P = 0.005）。未观察到SII与BMD或FRAX值之间存在显著相关性。在我们的队列中，全身炎症升高，特别是由CRP和SII表明，与骨质疏松性骨折状态和低骨密度有关。这些发现支持炎症途径可能导致骨质疏松症和骨折风险的概念，并表明炎症标志物可作为骨折风险评估的辅助工具。需要进一步的研究来阐明因果关系，并评估针对慢性炎症是否可以改善老年人的骨骼健康。
