Association between leukocyte-based inflammatory indices and bone mineral density in hemodialysis patients

Javid Mohammadzadeh Azarabadi; Neveen Shalalfa

Article Details

Association between leukocyte-based inflammatory indices and bone mineral density in hemodialysis patients

Authors:

Javid Mohammadzadeh Azarabadi | Neveen Shalalfa

Publisher:

MediHealth Academy Yayıncılık

Main Topics:

Ortopedi

Journal:

Journal of Medicine and Palliative Care Vol.6 Issue 2, pp.131-137

Document Type:

Article

Publication Date:

3/2025

Document Language:

English

Document ID (Org No.):

2001343398

pISSN:

2717-7505

Keywords:

Abstract:

 Aims: Osteoporosis and osteopenia are common among hemodialysis HD patients, yet current methods for risk stratification remain limited. This study aimed to investigate the relationship between leukocyte-based inflammatory indices and osteoporosis and osteopenia in HD patients and to assess their diagnostic performance in differentiating these conditions. Methods: A retrospective analysis was conducted on 168 HD patients classified into normal bone mineral density BMD n43, osteopenia n70, and osteoporosis n55 based on T-scores by dual-energy X-ray absorptiometry measurements. The leukocyte-based inflammatory indices were calculated as follows: Platelet to lymphocyte ratio PLRplatelet count lymphocyte count ratio; neutrophil o lymphocyte ratio NLRneutrophil count lymphocyte count ratio; systemic immune inflammation index SIIplatelet countneutrophil count  lymphocyte count ratio, and systemic inflammation response index SIRIneutrophil countmonocyte count lymphocyte count ratio. Results: Osteopenia and osteoporosis were identified in 41.7 and 32.7 of patients, respectively. Patients with osteoporosis exhibited higher neutrophil and monocyte counts and lower lymphocyte count p0.001. All inflammatory indices were higher in osteoporosis group compared to other group. Also, these indices were higher in osteopenia group compared to normal BMD group. SIRI showed the strongest discriminative power for differentiating osteopenia from normal BMD AUC0.84; sensitivity81.4; specificity79.2, p0.001 and osteoporosis from osteopenia AUC0.86; sensitivity82.5; specificity78.6; p0.001. Conclusion: Leukocyte-based inflammatory indices, particularly SIRI, are significantly associated with reduced BMD in HD patients and may serve as accessible biomarkers for identifying those at heightened risk of osteopenia and osteoporosis.

 Aims: Osteoporosis and osteopenia are common among hemodialysis HD patients, yet current methods for risk stratification remain limited. This study aimed to investigate the relationship between leukocyte-based inflammatory indices and osteoporosis and osteopenia in HD patients and to assess their diagnostic performance in differentiating these conditions. Methods: A retrospective analysis was conducted on 168 HD patients classified into normal bone mineral density BMD n43, osteopenia n70, and osteoporosis n55 based on T-scores by dual-energy X-ray absorptiometry measurements. The leukocyte-based inflammatory indices were calculated as follows: Platelet to lymphocyte ratio PLRplatelet count lymphocyte count ratio; neutrophil o lymphocyte ratio NLRneutrophil count lymphocyte count ratio; systemic immune inflammation index SIIplatelet countneutrophil count  lymphocyte count ratio, and systemic inflammation response index SIRIneutrophil countmonocyte count lymphocyte count ratio. Results: Osteopenia and osteoporosis were identified in 41.7 and 32.7 of patients, respectively. Patients with osteoporosis exhibited higher neutrophil and monocyte counts and lower lymphocyte count p0.001. All inflammatory indices were higher in osteoporosis group compared to other group. Also, these indices were higher in osteopenia group compared to normal BMD group. SIRI showed the strongest discriminative power for differentiating osteopenia from normal BMD AUC0.84; sensitivity81.4; specificity79.2, p0.001 and osteoporosis from osteopenia AUC0.86; sensitivity82.5; specificity78.6; p0.001. Conclusion: Leukocyte-based inflammatory indices, particularly SIRI, are significantly associated with reduced BMD in HD patients and may serve as accessible biomarkers for identifying those at heightened risk of osteopenia and osteoporosis.

 Aims: Osteoporosis and osteopenia are common among hemodialysis HD patients, yet current methods for risk stratification remain limited. This study aimed to investigate the relationship between leukocyte-based inflammatory indices and osteoporosis and osteopenia in HD patients and to assess their diagnostic performance in differentiating these conditions. Methods: A retrospective analysis was conducted on 168 HD patients classified into normal bone mineral density BMD n43, osteopenia n70, and osteoporosis n55 based on T-scores by dual-energy X-ray absorptiometry measurements. The leukocyte-based inflammatory indices were calculated as follows: Platelet to lymphocyte ratio PLRplatelet count lymphocyte count ratio; neutrophil o lymphocyte ratio NLRneutrophil count lymphocyte count ratio; systemic immune inflammation index SIIplatelet countneutrophil count  lymphocyte count ratio, and systemic inflammation response index SIRIneutrophil countmonocyte count lymphocyte count ratio. Results: Osteopenia and osteoporosis were identified in 41.7 and 32.7 of patients, respectively. Patients with osteoporosis exhibited higher neutrophil and monocyte counts and lower lymphocyte count p0.001. All inflammatory indices were higher in osteoporosis group compared to other group. Also, these indices were higher in osteopenia group compared to normal BMD group. SIRI showed the strongest discriminative power for differentiating osteopenia from normal BMD AUC0.84; sensitivity81.4; specificity79.2, p0.001 and osteoporosis from osteopenia AUC0.86; sensitivity82.5; specificity78.6; p0.001. Conclusion: Leukocyte-based inflammatory indices, particularly SIRI, are significantly associated with reduced BMD in HD patients and may serve as accessible biomarkers for identifying those at heightened risk of osteopenia and osteoporosis.

 Amaç: Osteoporoz ve osteopeni, hemodiyaliz HD hastalarında yaygın olarak görülmektedir, ancak mevcut risk sınıflandırma yöntemleri sınırlıdır. Bu çalışma, HD hastalarında lökosit bazlı enflamatuar indeksler ile osteoporoz ve osteopeni arasındaki ilişkiyi araştırmayı ve bu indekslerin bu durumları ayırt etmedeki tanısal performansını değerlendirmeyi amaçladı. Yöntemler: İkili enerji X-ray absorbsiyometri ölçümleri ile T skorlarına göre normal kemik mineral yoğunluğu KMY n43, osteopeni n70 ve osteoporoz n55 olarak sınıflandırılan 168 hemodiyaliz hastası üzerinde retrospektif bir analiz yapıldı. Lökosit bazlı enflamatuar indeksler aşağıdaki şu şekilde hesaplandı: Trombosit-Lenfosit Oranı PLR  trombosit sayısı  lenfosit sayısı; Nötrofil-Lenfosit Oranı NLR  nötrofil sayısı  lenfosit sayısı; Sistemik İmmün Enflamasyon İndeksi SII  trombosit sayısı  nötrofil sayısı  lenfosit sayısı; Sistemik Enflamasyon Yanıt İndeksi SIRI  nötrofil sayısı  monosit sayısı  lenfosit sayısı. Bulgular: Hastaların 41,7sinde osteopeni, 32,7sinde osteoporoz tespit edildi. Osteoporozu olan hastalarda nötrofil ve monosit sayıları daha yüksek, lenfosit sayıları ise daha düşüktü p  0,001. Tüm enflamatuar indeksler, osteoporoz grubunda diğer gruplara kıyasla daha yüksek bulundu. Ayrıca, osteopeni grubunda da normal KMY grubuna göre daha yüksek değerler gözlendi. SIRI, osteopeniyi normal KMYden ayırt etmede en güçlü belirleyici olarak tespit edildi AUC  0,84; duyarlılık  81,4; özgüllük  79,2; p  0,001. Osteoporozu osteopeniden ayırt etmede de güçlü bir performans gösterdi AUC  0,86; duyarlılık  82,5; özgüllük  78,6; p  0,001. Sonuç: Lökosit bazlı enflamatuar indeksler, özellikle SIRI, HD hastalarında düşük KMY ile anlamlı şekilde ilişkilidir ve osteopeni ve osteoporoz riski yüksek olan hastaları belirlemede kolay erişilebilir biyogöstergeler olarak kullanılabilir.

Article Details

Association between leukocyte-based inflammatory indices and bone mineral density in hemodialysis patients

Authors:

Javid Mohammadzadeh Azarabadi | Neveen Shalalfa

Publisher:

MediHealth Academy Yayıncılık

Main Topics:

Ortopedi

Journal:

Journal of Medicine and Palliative Care Vol.6 Issue 2, pp.131-137

Document Type:

Article

Publication Date:

3/2025

Document Language:

English

Document ID (Org No.):

2001343398

pISSN:

2717-7505

Bone mineral density

hemodialysis

osteoporosis

systemic inflammationemik Mineral Yoğunluğu

Hemodiyaliz

Osteoporoz

Sistemik Enflamasyon

Issues

Article Details

Authors: Javid Mohammadzadeh Azarabadi | Neveen Shalalfa

Publisher: MediHealth Academy Yayıncılık

Main Topics: Ortopedi

Journal: Journal of Medicine and Palliative Care Vol.6 Issue 2, pp.131-137

Document Type: Article

Publication Date: 3/2025

Document Language: English

Document ID (Org No.): 2001343398

pISSN: 2717-7505

Issues

Authors:

Javid Mohammadzadeh Azarabadi | Neveen Shalalfa

Publisher:

MediHealth Academy Yayıncılık

Main Topics:

Ortopedi

Journal:

Journal of Medicine and Palliative Care Vol.6 Issue 2, pp.131-137

Document Type:

Article

Publication Date:

3/2025

Document Language:

English

Document ID (Org No.):

2001343398

pISSN:

2717-7505