Associations of the Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio with Osteoporosis: A Meta-Analysis

Abstract

Osteoporosis is characterized by low bone mass and increased bone fragility. Numerous studies have suggested that inflammation contributes to its pathogenesis. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are simple, noninvasive biomarkers that can reflect the inflammation status on human body. However, evidence on their associations with osteoporosis remains scant. The PubMed, Embase, and Cochrane Library databases were searched for relevant studies from their inception to April 2022. Observational studies providing complete NLR or PLR data in both the osteoporosis and normal bone mineral density (BMD) groups were included. Studies involving individuals at risk of secondary osteoporosis or restricted to a certain disease population were excluded. The main outcome was the associations of NLR and PLR with osteoporosis. Between-group differences were measured using mean differences (MDs) and 95% confidence intervals (CIs). In our analysis, both NLR and PLR were significantly higher in the osteoporosis group (MD = 0.494, 95% CI: 0.339–0.649, p < 0.0001; MD = 23.33, 95% CI: 4.809–41.850, p = 0.014, respectively) than in the normal BMD group. NLR was significantly higher in postmenopausal women with osteoporosis (MD = 0.432, 95% CI: 0.309–0.544, p < 0.0001). Our findings suggest the associations of NLR and PLR with osteoporosis. NLR and PLR constitute potential targets in osteoporosis screening.

Association between systemic inflammatory response index and bone turnover markers in Chinese patients with osteoporotic fractures: a retrospective cross-sectional study

“…These findings also suggest that SIRI values may serve as a tool for evaluating the risk of OPFs. Consistent with prior research ( 42 , 48 , 49 ), the present study demonstrated that a strong inflammatory response is detrimental to the prognosis of individuals with OP.…”

“…Inflammatory mechanisms underlying OP have also been proposed in recent years ( 40 , 41 ). It is evident that inflammation alters bone homeostasis, resulting in reduced bone mass, weaker bone strength, and decreased bone density, as well as ultimately a decrease in bone turnover, all of which contribute to adverse outcomes in OPFs ( 42 , 43 ). Increased circulating levels of pro-inflammatory cytokines and immune cells directly or indirectly affect bone turnover through various pathways ( 44 , 45 ).…”

Comparing the Prognostic Roles of Red Blood Cell Volume Distribution Width, Neutrophil–Lymphocyte Ratio, and Platelet–Lymphocyte Ratio for Predicting Mortality after Hip Fracture in the Geriatric Population

“…Given the projected global increase in hip fracture, addressing the substantial hip fracture-associated health risks of older adults is crucial (1). Numerous studies have identi ed a positive association between postoperative mortality and various in ammatory parameters related to hip fracture surgery, including RDW (11,(16)(17)(18)(19), NLR (6,11,16,20,21), PLR (16, 21-23), C-reactive protein level (24), albumin level (25), and total lymphocyte count (25). To date, no prospective study has compared single laboratory parameters as prognostic factors for the mortality risk associated with hip fracture.…”