Systemic immune‐inflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture

Fang, Hong; Zhang, Hanqing; Wang, Zhi; Zhou, Zhongming; Li, Yunjun; Lin, Li

doi:10.1002/jcla.23016

Cited by 71 publications

(88 citation statements)

References 29 publications

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“…In a study of postmenopausal Korean women, it was shown that NLR was negatively associated with the mean lumbar BMD [26]. In a report of a large group of postmenopausal women, Fang et al observed that NLR was an independent risk factor for postmenopausal osteoporosis [34]. Moreover, several studies have shown that an elevated NLR was associated with poor prognosis in osteoporotic individuals [5,27].…”

Section: Discussionmentioning

confidence: 99%

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The relationship of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with bone mineral density in adolescent girls suffering from anorexia nervosa

Morawiecka-Pietrzak

Malczyk

Dąbrowska

et al. 2021

Endokrynologia Polska

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Introduction: Inflammation is supposed to be one of the factors contributing to decreased bone mineral density (BMD) in anorexia nervosa (AN). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are simple and cost-effective inflammatory markers, well documented as indicators of postmenopausal osteoporosis. This study aimed to assess the relationships between these ratios and BMD in girls with AN. Material and methods:The electronic records of 73 girls hospitalized for AN were analysed retrospectively. The age range of the study group was 12.56-17.67 years. BMD was assessed by dual-energy X-ray absorptiometry (DXA) and expressed as Z-scores according to lumbar spine (s-BMD) and total body (TB-BMD) sites. NLR and PLR were calculated according to complete blood count results. Patients were divided into 2 subgroups with parallel analysesaccording to the TB-BMD criterion and the s-BMD criterion: normal (Z-score > -2.0, n = 63) and low s-BMD subgroup (Z-score ≤ -2.0, n = 10), and normal (Z-score > -2.0, n = 45) and low TB-BMD subgroup (Z-score ≤ -2.0, n = 28).Results: In the low s-BMD subgroup a tendency to an increase of mean NLR, PLR, and WBC values was observed. Respective BMD Z-score values correlated significantly and negatively with PLR in the low s-BMD (R = -0.892, p < 0.001) and normal TB-BMD (R = -0.451, p = 0.002) subgroups, while with NLR only in the normal TB-BMD subgroup (R = -0.685, p < 0.001). In the low s-BMD subgroup the PLR was shown to be a significant and independent predictor of s-BMD (β = -0.881, p < 0.001). The PLR contributed to 77.6% of the s-BMD Z-score variability (R 2 = 0.776, p < 0.001). In the normal TB-BMD subgroup, the PLR and NLR levels were significant and independent predictors of TB-BMD (β = -0.352, p = 0.004; β = -0.450, p = 0.001; β = -0.339, p = 0.005, respectively) and explained 44.4% of TB-BMD Z-score variability (R 2 = 0.444, p < 0.001). Conclusions:These results indicate that there might be a relationship between bone mass loss and inflammation expressed as NLR and PLR in adolescent girls suffering from AN. These connections seem to be dependent on the examined skeletal area. NLR and PLR, which are common indicators of morbidity and mortality in many malignancies and inflammatory chronic diseases, can also be useful in the evaluation of bone condition in adolescent females with AN. However, there is a need for further investigation in this field.

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Section: Discussionmentioning

confidence: 99%

“…NLR and PLR were reported to be closely related to systemic inflammation and immune response status [34]. Recent data showed that raised NLR and/or PLR were associated with i.a.…”

Section: Discussionmentioning

confidence: 99%

The relationship of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with bone mineral density in adolescent girls suffering from anorexia nervosa

Morawiecka-Pietrzak

Malczyk

Dąbrowska

et al. 2021

Endokrynologia Polska

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“…The systemic immune-inflammation index (SII), which is a composite indicator integrating platelet, neutrophil and lymphocyte counts, has been proven to be a promising prognostic predictor in various diseases, including malignant tumors [ 20 – 22 ], coronary artery disease [ 23 ], acute ischemic stroke [ 24 ], and preterm premature rupture of the membranes [ 25 ]. Moreover, high SII (≥834.89) was newly identified as a good risk predictor for discriminating osteoporotic fracture risk in postmenopausal osteoporosis patients [ 26 ]. Recently, we also firstly reported that high platelet-to-lymphocyte ratio (PLR) was associated with increased 1 year all-cause mortality in older adults with hip fracture [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Systemic immune-inflammation index independently predicts poor survival of older adults with hip fracture: a prospective cohort study

et al. 2021

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Background The systemic immune-inflammation index (SII), based on peripheral platelet, neutrophil and lymphocyte counts, has been proven to be a promising prognostic indicator in various diseases. Hip fracture is a common injury among the older adults, and has become a global public health problem with high mortality and disability rates. However, the relationship between SII and the prognosis of hip fracture is not yet well-known. The aim of the this study was to explore the predictive value of SII in older adults with hip fracture undergoing surgery. Methods This was a prospective cohort study performed from January 2014 to December 2018 at a orthopaedic center, China. The SII was calculated as platelet×neutrophil/lymphocyte counts. Univariable and multivariable Cox proportional hazard models were used to assess the association between SII and all-cause mortality. Results A total of 290 older adults with hip fracture were included, and the mean (SD) age was 77.6 (8.6) years, and 189 (65.2%) were female. The median (IQR) SII was 759.4 (519.0–1128.7) × 109/L. After a median follow-up time of 33.4 months, 13 (4.5%), 26 (9.0%) and 54 (18.6%) patients died within the 30-day, 1-year and last follow-up, respectively. Multivariable Cox analysis revealed that each increase of 100 units of SII was associated with a 8% increased hazard of death at 1-year follow-up (HR = 1.08, 95% CI: 1.01–1.17, p = 0.033), and 9% increased hazard of death at last follow-up (HR = 1.09, 95% CI: 1.03–1.15, p = 0.003). Conclusions SII is associated with poor all-cause mortality in older adults with hip fracture undergoing surgery, and deserves further investigation and application in clinical practice.

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“…It takes two aspects, inflammation and immunity, into consideration. Someone assumed that good performance of SII might owe to the integration of three indexes, which avoid being easily affected by individual differences and show greater stability ( 2 , 21 , 36 ). That may be exactly the same as SIRI.…”

Section: Discussionmentioning

confidence: 99%

“…In the recent few years, the exacerbation of COPD has become the focus of our attention. It contributed to a series of problems ( 2 , 3 )—worsening lung function, decreasing life quality ( 4 , 5 ), accelerating disease progress, and elevating the risk of hospitalization or mortality ( 3 , 6 , 7 ). Recently, the use of hemogram indexes indicating systemic inflammation has been determined in clinical practice for predicting hospitalization and mortality in COPD.…”

Section: Introductionmentioning

confidence: 99%

The Combination of Hemogram Indexes to Predict Exacerbation in Stable Chronic Obstructive Pulmonary Disease

Liu

Feng

et al. 2020

Front. Med.

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Background: Chronic obstructive pulmonary disease (COPD) is characterized by pulmonary and systemic inflammatory processes, and exacerbation of COPD represents a critical moment in the progression of COPD. Several biomarkers of inflammation have been proposed to have a predictive function in acute exacerbation. However, their use is still limited in routine clinical practice. The purpose of our study is to explore the prognostic efficacy of novel inflammatory hemogram indexes in the exacerbation among stable COPD patients.Method: A total of 275 stable COPD patients from the Shanghai COPD Investigation Comorbidity Program were analyzed in our study. Blood examinations, especially ratio indexes like platelet–lymphocyte ratio (PLR), platelet × neutrophil/lymphocyte ratio [systemic immune-inflammation index (SII)], and monocyte × neutrophil/lymphocyte ratio [systemic inflammation response index (SIRI)], lung function test, CT scans, and questionnaires were performed at baseline and routine follow-ups. Clinical characteristics and information of exacerbations were collected every 6 months. The relationship between hemogram indexes and diverse degrees of exacerbation was assessed by logistic regression. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the ability of hemogram indexes to predict exacerbation of COPD. Furthermore, the discrimination and accuracy of combined indexes were measured by ROC and calibration curve.Result: There was a significant positive correlation between PLR levels and total exacerbation of COPD patients in a stable stage in a year. Also, the predictive ability of PLR exceeded any other ratio indexes, with an AUC of 0.66. SII and SIRI ranked second only to PLR, with an AUC of 0.64. When combining PLR with other indexes (sex, COPD year, and St. George's Respiratory Questionnaire scores), they were considered as the most suitable panel of index to predict total exacerbation. Based on the result of the ROC curve and calibration curve, the combination shows optimal discrimination and accuracy to predict exacerbation events in COPD patients.Conclusion: The hemogram indexes PLR, SII, and SIRI were associated with COPD exacerbation. Moreover, the prediction capacity of exacerbation was significantly elevated after combining inflammatory hemogram index PLR with other indexes, which will make it a promisingly simple and effective marker to predict exacerbation in patients with stable COPD.

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Systemic immune‐inflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture

Cited by 71 publications

References 29 publications

The relationship of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with bone mineral density in adolescent girls suffering from anorexia nervosa

The relationship of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with bone mineral density in adolescent girls suffering from anorexia nervosa

Systemic immune-inflammation index independently predicts poor survival of older adults with hip fracture: a prospective cohort study

The Combination of Hemogram Indexes to Predict Exacerbation in Stable Chronic Obstructive Pulmonary Disease

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