Calcium2026

Evaluation of inflammatory and cardiovascular-related indices as potential markers for postmenopausal osteoporosis-a retrospective study.

Tigli Alihan, Baykus Yakup, Sener Nazli, De Girmenci Yasemin Ercan et al. — PeerJ

Summary

This study investigated whether certain inflammatory and cardiovascular-related blood markers could help diagnose postmenopausal osteoporosis. Researchers analyzed data from 387 postmenopausal women, comparing various ratios like monocyte/HDL-C and triglyceride-glucose index between those with and without osteoporosis. Although the monocyte/HDL-C ratio showed a statistical difference, it was not accurate enough to reliably identify osteoporosis. Therefore, these markers are not recommended as independent screening tools for postmenopausal osteoporosis.

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Abstract

BACKGROUND: Emerging evidence suggests a strong pathophysiological link between osteoporosis (OP), characterized by low bone mineral density (BMD), and cardiovascular disease. Biomarkers such as the atherogenic index of plasma (AIP) and the triglyceride-glucose (TyG) index, while primarily linked to cardiovascular risk, may also reflect the metabolic dysregulation seen in OP. Similarly, inflammatory markers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and neutrophil-monocyte ratio (NMR), along with ratios like lymphocyte/HDL-C, monocyte/HDL-C, and granulocyte/HDL-C have been suggested as potential diagnostic tools. The aim of this study was to evaluate the diagnostic discrimination of these accessible biomarkers for postmenopausal OP. METHODS: A retrospective analysis was performed on 387 postmenopausal women who underwent bone densitometry between 2021 and 2025. Data on body mass index (BMI), T-scores, age, menopause duration, and relevant laboratory parameters were collected. Inflammatory and biochemical indices were calculated using established formulas. RESULTS: Age and menopause duration were significantly higher in the OP group compared to the normal and osteopenia groups ( < 0.01). Conversely, the median femoral neck T-score (FN-T) was significantly lower in the OP group. Among the biomarkers, only the monocyte/HDL-C ratio was significantly lower in the OP group ( < 0.05). Receiver operating characteristic (ROC) analysis indicated poor diagnostic discrimination for the monocyte/HDL-C ratio (AUC: 0.608), while all other biomarkers were non-significant (AUC < 0.6). CONCLUSION: Even the statistically significant monocyte/HDL-C ratio failed to achieve clinically acceptable discriminatory ability. Consequently, these biomarkers cannot be recommended as standalone screening tools for postmenopausal osteoporosis.

View on PubMed →DOI: 10.7717/peerj.21311