Abstract
INTRODUCTION: Several research studies have indicated a possible association between markers of systemic inflammation and osteoporosis. Nevertheless, the precise relationship is still unclear due to the insufficient number of studies, necessitating additional research. The objective of this study was to examine the connection between systemic inflammation markers (SIMs) and the incidence of osteoporosis and osteopenia. MATERIALS AND METHODS: Data were gathered from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States from 2009 to 2018. To evaluate the relationships between four systematic immune-inflammation markers-systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR)-and the occurrence of osteoporosis and osteopenia, a multivariate logistic regression analysis was utilized. Odds ratios (OR) along with 95% confidence intervals (CI) were calculated. RESULTS: Multivariate regression analysis revealed that female gender, lower BMI, and older age were identified as risk factors for osteoporosis, while having a higher family income-to-poverty ratio was found to be a protective factor. Among SIMs, only PLR was significantly associated with the prevalence of osteoporosis. Individuals in the highest tertiles of PLR had a 1.221-fold increase in osteoporosis prevalence compared to those in the lowest tertiles (OR = 1.221, CI = 1.001-1.488, P = 0.048). Subgroup analysis indicated stronger associations between NLR and osteoporosis in older individuals or males. Regarding osteopenia, NLR emerged as a significant protective factor for its prevalence. Interestingly, subgroup analysis revealed stronger associations between SIMs and osteopenia in younger individuals or females. CONCLUSION: Not all SIMs demonstrated significant associations with osteoporosis and osteopenia. An increased PLR has been recognized as a possible risk factor for osteoporosis, whereas a high NLR might act as a protective factor against osteopenia. Additionally, it is crucial to highlight that the predictive value of SIMs can vary among individuals depending on their age and gender.