Investigation of inflammatory biomarkers and their relationship with bone mineral density in postmenopausal women with osteoporosis

Year 2022, Volume: 4 Issue: 4, 165 - 170, 06.12.2022

Ramazan Erda Pay , Büşra Şahin , Gülsemin Ertürk Çelik , Yaprak Ustun

https://doi.org/10.46969/EZH.1162134

Abstract

Objective: The aim of this study is to examine the relationship between inflammatory biomarker values and bone mineral density (BMD) in patients with and without postmenopausal osteoporosis.
Material and Methods: This retrospective observational study includes 93 patients who applied to Health Sciences University Etlik Zübeyde Hanım Gynecology Training and Research Hospital for routine control and required to have BMD between May 2021 and January 2022. According to the mean lumbar BMD T-score value from the BMD results performed with Dual Energy X-Ray Absorbsiometry (DEXA); T-score <-2.5 was defined as osteoporosis. The study population was divided into two groups as postmenopausal women with and without osteoporosis. Demographic and clinical characteristics, biochemical parameters, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) and systemic immune inflammation index (SII) values of the two groups were compared. Correlation between systemic inflammatory response and BMD was examined.
Results: A total of 93 postmenopausal women were included in the study. The mean T-score was -3.05 in patients with osteoporosis (n:49) and 3.64 in the non-osteoporosis group (n:44), with a statistically significant difference (p<0.05). There was no statistically significant difference between patients with and without osteoporosis in terms of Neutrophil/Lymphocyte ratio (NLR) and Platelet/Lymphocyte Ratio (PLR) and Systemic immune inflammation index (SII) values (p>0.05). No correlation was observed between NLR, PLR and SII values and T score (p>0.05).
Conclusion: In our study, no relationship was observed between inflammatory biomarkers and bone mineral density in postmenopausal women with osteoporosis. Although multicenter studies with larger numbers of patients are needed, studies in the literature show that inflammatory biomarkers obtained from hemogram parameters can play an important role in the screening and prevention of postmenopausal osteoporosis.

Keywords

Postmenopausal osteoporosis, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, Systemic immune inflammation index, Bone mineral density

Postmenopozal osteoporozlu kadınlarda inflamatuar biyobelirteçlerin ve kemik mineral yoğunluğu ile ilişkisinin incelenmesi

Abstract

Amaç: Postmenopozal osteoporozu olan ve olmayan hastalar arasında inflamatuar biyobelirteç değerlerinin ve kemik mineral yoğunluğu (KMY) ile ilişkisinin incelenmesidir.
Gereç ve Yöntem: Retrospektif gözlemsel çalışmamıza Sağlık Bilimleri Üniversitesi Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim Araştırma Hastanesi’ne Mayıs 2021 ve Ocak 2022 tarihleri arasında rutin kontrol için başvuran ve KMY istenen 93 hasta dahil edildi. ‘Dual Enerji X ray Absorbsiyometri (DEXA) ile yapılan KMY sonuçlarından ortalama lumbal KMY T-skoru değerine göre; T-skoru <-2.5 osteoporoz olarak tanımlandı. Çalışma popülasyonu osteoporozu olan ve olmayan postmenopozal kadınlar olarak iki gruba ayrıldı. İki grubun demografik ve klinik özellikleri, biyokimyasal parametreleri, nötrofil/lenfosit oranı (NLR) ve platelet/lenfosit oranı (PLR) ve sistemik immün inflamasyon indeksi (SII) değerleri karşılaştırıldı. Sistemik inflamatuar yanıt ile KMY arasında korelasyon incelendi.
Bulgular: Çalışmaya toplam 93 postmenopozal kadın dahil edildi. Osteoporoz olan (n:49) hastalarda ortalama T- skoru -3,05, osteoporoz olmayan (n:44) grupta ise 3,64 olup istatistiksel olarak anlamlı fark izlendi (p<0,05). Osteoporoz olan ve olmayan hastalar arasında NLR, PLR ve SII değerleri açısından istatiksel olarak anlamlı fark izlenmedi (p>0,05). T-skoru ile NLR, PLR ve SII değerleri arasında korelasyon izlenmedi (p>0,05).
Sonuç: Çalışmamızda, postmenopozal osteoporozlu kadınlarda inflamatuar biyobelirteçler ve kemik mineral yoğunluğu arasında ilişki izlenmemiştir. Çok merkezli ve daha çok hasta sayılı çalışmalara ihtiyaç olmakla beraber, literatürdeki çalışmalar hemogram parametrelerinden elde edilen inflamatuar biyobelirteçlerin postmenopozal osteoporozun taranması ve önlenmesinde önemli bir rol oynayabileceğini göstermektedir.

Keywords

Postmenopozal osteoporoz, nötrofil/lenfosit oranı, trombosit/lenfosit oranı, Sistemik immün inflamasyon indeksi, Kemik mineral yoğunluğu

References

• Black DM, Rosen CJ. Clinical Practice. Postmenopausal Osteoporosis. N Engl J Med 2016;374(3):254-262. doi: 10.1056/NEJMcp1513724. Erratum in: N Engl J Med. ;374(18):1797.
• Eastell R, Szulc P. Use of bone turnover markers in postmenopausal osteoporosis. Lancet Diabetes Endocrinol 2017;5(11):908-923.
• Rachner TD, Khosla S, Hofbauer LC. Osteoporosis: now and the future. Lancet 2011;377(9773):1276-1287.
• Wang L, Hu YQ, Zhao ZJ, et al. Screening and validation of serum protein biomarkers for early postmenopausal osteoporosis diagnosis. Mol Med Rep 2017;16(6):8427-8433.
• Lerner UH. Inflammation-induced bone remodeling in periodontal disease and the influence of post-menopausal osteoporosis. J Dent Res 2006;85(7):596-607.
• Al-Daghri NM, Aziz I, Yakout S, et al. Inflammation as a contributing factor among postmenopausal Saudi women with osteoporosis. Medicine (Baltimore) 2017 ;96(4):e5780.
• Azizieh F, Raghupathy R, Shehab D, Al-Jarallah K, Gupta R. Cytokine profiles in osteoporosis suggest a proresorptive bias. Menopause 2017;24(9):1057-1064.
• Lee SH, Ryu SY, Park J, Shin MH, Han MA, Choi SW. The Relationship of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio with Bone Mineral Density in Korean Postmenopausal Women. Chonnam Med J 2019;55(3):150-155.
• Wang L, Wang C, Wang J, Huang X, Cheng Y. A novel systemic immune-inflammation index predicts survival and quality of life of patients after curative resection for esophageal squamous cell carcinoma. J Cancer Res Clin Oncol 2017;143(10):2077-2086.
• Pietschmann P, Mechtcheriakova D, Meshcheryakova A, Föger-Samwald U, Ellinger I. Immunology of Osteoporosis: A Mini-Review. Gerontology 2016;62(2):128-137.
• Poubelle PE, Chakravarti A, Fernandes MJ, Doiron K, Marceau AA. Differential expression of RANK, RANK-L, and osteoprotegerin by synovial fluid neutrophils from patients with rheumatoid arthritis and by healthy human blood neutrophils. Arthritis Res Ther 2007;9(2):R25.
• Huang C, Li S. Association of blood neutrophil lymphocyte ratio in the patients with postmenopausal osteoporosis. Pak J Med Sci 2016;32(3):762-765.
• Yilmaz H, Uyfun M, Yilmaz TS, et al. Neutrophil-lymphocyte ratio may be superior to C-reactive protein for predicting the occurrence of postmenopausal osteoporosis. Endocr Regul 2014;48(1):25-33.
• Sharif PS, Abdollahi M. The role of platelets in bone remodeling. Inflamm Allergy Drug Targets 2010;9(5):393-399.
• Luo H, He L, Zhang G,et al. Normal Reference Intervals of Neutrophil-To-Lymphocyte Ratio, Platelet-To-Lymphocyte Ratio, Lymphocyte-To-Monocyte Ratio, and Systemic Immune Inflammation Index in Healthy Adults: a Large Multi-Center Study from Western China. Clin Lab 2019;65(3).
• Fang H, Zhang H, Wang Z, Zhou Z, Li Y, Lu L. Systemic immune-inflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture. J Clin Lab Anal 2020;34(1):e23016.
• Du YN, Chen YJ, Zhang HY, Wang X, Zhang ZF. Inverse association between systemic immune-inflammation index and bone mineral density in postmenopausal women. Gynecol Endocrinol 2021;37(7):650-654.