Systemic Inflammation Markers Associated with Bone Mineral Density in perimenopausal and Postmenopausal Women

Abstract

Objective

The aim of this research was to determine whether systemic inflammatory indicators, including aggregate index of systemic inflammation (AISI), neutrophils lymphocyte to platelet ratio (NLPR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI), are related to bone mineral density (BMD) in perimenopausal and postmenopausal women.

Methods

One hundred and eighty-one perimenopausal and 390 postmenopausal women were enrolled in this cross-sectional study. Continuous variables by analysis of variance and Kruskal Wallis test for comparing the clinical characteristics. Linear regression analysis was conducted to investigate the associations between inflammatory indicators with BMD. The comparison between the subgroups was performed using the nonparametric test and the T-test.

Results

AISI, NLPR, SII, and SIRI quartile values were inversely associated with BMD in menopausal women (P = 0.021; P = 0.047; P < 0.001; P < 0.001, respectively). After adjusting for confounding factors, four inflammatory indicators remained significantly associated with BMD (all P for trend <0.001). Analysis according to menopausal status demonstrated that AISI, SII, and SIRI were significantly correlated with mean femoral neck BMD in postmenopausal women (P for trend = 0.015, 0.004, and 0.001), but not significantly associated with BMD in perimenopausal women (P for trend = 0.248, 0.054, and 0.352) after adjustment for covariates.

Conclusion

The quartile values of AISI, SII, and SIRI were inversely associated with BMD in postmenopausal women, following adjustment for individual variables, hormone profiles and glucolipid metabolism profiles. AISI, SII, and SIRI have potential to be important tools for screening and prevention of bone loss in menopausal women in future clinical practice.

Keywords:

• menopause
• female
• femur neck
• cross-sectional studies
• regression analysis
• inflammation

Abbreviations

AISI, aggregate index of systemic inflammation; ANOVA, analysis of variance; BMD, bone mineral density; BMI, body mass index; CRP, C reactive protein; E2, estradiol; FSH, follicle stimulating hormone; HCY, homocysteine; HDL, high-density lipoprotein; HOMA-IR, homeostatic model assessment index of insulin resistance; L, lymphocytes; LDL, low-density lipoprotein; LH, luteinizing hormone; M, monocytes; MLR, monocyte lymphocyte ratio; N, neutrophils; NLR, neutrophil to lymphocyte ratio; NLPR, neutrophils lymphocyte to platelet ratio; PLT, platelets; PLR, platelet to lymphocyte ratio; PMOP, postmenopausal osteoporosis; SII, systemic immune-inflammation index; SIRI, systemic inflammation response index; T, testosterone; TSH, thyroid-stimulating hormone; WBC, white blood cell.

Acknowledgments

This research was supported by the Training Program for Young and Middle-aged Doctors in Bethune Women‘s Health Research Project (X-J-2019-024); Zhejiang Province Major Science and Technology Program of Medicine and Health (WKJ-ZJ-2010); Hangzhou Agriculture and Social Development Research Project (202004A12, 202204B21); Special Project of Traditional Chinese Medicine Modernization of Zhejiang Province (2021ZX013); Medical and Health Science and Technology Project of Zhejiang Province (2022KY275). Yijie Chen and Jingjing Yu are co-first authors for this study. Zhifen Zhang and Xuejing Jin are co-correspondence authors for this study.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.