Systemic immune-inflammation index and bone mineral density in postmenopausal women: A cross-sectional study of the national health and nutrition examination survey (NHANES) 2007-2018

Abstract

BackgroundThis study aimed to investigate the association between the systemic immune-inflammation index (SII) and bone mineral density (BMD) and to determine the association between the SII and the risk of osteopenia/osteoporosis among postmenopausal women aged ≥50 years.MethodsPostmenopausal women aged ≥50 years from the National Health and Nutrition Examination Survey were included. BMD testing was performed using dual-energy X-ray absorptiometry. The SII was calculated based on lymphocyte (LC), neutrophil (NC), and platelet (PC) counts. Moreover, the associations of BMD with SII and other inflammatory markers, including platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), the product of platelet count and neutrophil count (PPN), PC, NC, and LC, were assessed using a multivariable weighted linear regression model. Additionally, the associations of low BMD/osteoporosis with SII and other inflammatory markers were assessed using multivariable weighted logistic regression.ResultsFinally, a total of 893 postmenopausal women with a weighted mean age of 60.90 ± 0.26 years were included finally. This study found that SII was negatively associated with total femur BMD and femoral neck BMD, and postmenopausal women in a higher SII quarter group showed low lumbar spine BMD than the lowest SII quarter group when SII was converted from a continuous variable to a categorical variable. Moreover, increased SII was associated with an increased risk of low BMD and osteoporosis. In addition, this study observed that other inflammatory markers, especially NLR and PPN, were negatively associated with BMD and positively associated with the risk of osteoporosis. Finally, the subgroup analysis showed that the associations between BMD and inflammatory markers were pronounced in postmenopausal women aged ≥65 years or those with normal BMI (<25 kg/m2).ConclusionSII may be a valuable and convenient inflammatory marker that could be applied to predict the risk of low BMD or osteoporosis among postmenopausal women aged ≥50. Moreover, postmenopausal women with a high level of SII or other inflammatory markers, such as NLR and PPN, should be aware of the potential risk of osteoporosis. However, given the inherent limitations of the present study, additional large-scale studies are required to investigate the role of SII in osteoporosis further.

The association between sex hormones and periodontitis among American adults: A cross-sectional study

“…The study population was restricted to participants with detailed sex hormone levels and a diagnosis of periodontitis. Considering the dramatic changes in hormone levels during the female physiological cycle, we chose only postmenopausal women who answered “no” to the question “Have you had at least one menstrual period in the past 12 months?” and answered “hysterectomy” or “menopause/life changes” to the question “What is the reason why you have not had a period in the last 12 months?” in the self-reported reproductive health questionnaire ( 29 ). Finally, 4,877 participants were included in the analysis, containing 3,222 males and 1,655 females.…”

“…and answered "hysterectomy" or "menopause/life changes" to the question "What is the reason why you have not had a period in the last 12 months?" in the self-reported reproductive health questionnaire (29). Finally, 4,877 participants were included in the analysis, containing 3,222 males and 1,655 females.…”

Systemic immune-inflammation index is associated with diabetic kidney disease in Type 2 diabetes mellitus patients: Evidence from NHANES 2011-2018

“…SII was independently associated with an increased risk factor for protein energy loss in patients receiving maintenance hemodialysis ( 28 ). Additionally, higher SII is associated with an increased risk of T2DM depression ( 29 ), disease activity in ulcerative colitis patients ( 30 ), peripheral arterial disease ( 31 ), urinary albumin excretion ( 32 ), testosterone deficiency ( 33 ), and osteoporosis in postmenopausal women ( 34 ).…”

Nocturnal sleep duration and bone mineral density: a cross-sectional study of the National Health and Nutrition Examination Survey (NHANES) 2007–2014

“…The selection of potential variables that might affect BMD was performed according to previous studies and accessibility data from the NHANES database [ 1 , 27 ]. Finally, age, sex/menopause status (the definition and information extraction of menopause status referred to a previous study [ 28 ]), race, education level, income level, body mass index (BMI), smoking status, alcohol drinking status, physical activity level, sedentary activity, fracture history, glucocorticoid use, family history of osteoporosis, Charlson Comorbidity Index (CCI) (the definition and information extraction of CCI referred to a previous study [ 29 ]), calcium intake and caffeine intake were considered to be potential covariates in the present study. Other detailed information on the covariates is listed in Supplementary Table S 1 .…”