閉経後骨粗鬆症の潜在的マーカーとしての炎症性および心血管関連指標の評価：レトロスペクティブ研究

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.