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

Authors : Javid Mohammadzadeh Azarabadi, Neveen Shalalfa
Pages : 131-137
Doi:10.47582/jompac.1642972
View : 31 | Download : 31
Publication Date : 2025-03-23
Article Type : Research Paper
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) (n=43), osteopenia (n=70), and osteoporosis (n=55) based on T-scores by dual-energy X-ray absorptiometry measurements. The leukocyte-based inflammatory indices were calculated as follows: Platelet to lymphocyte ratio (PLR)=platelet count/ lymphocyte count ratio; neutrophil o lymphocyte ratio (NLR)=neutrophil count/ lymphocyte count ratio; systemic immune inflammation index (SII)=platelet count×neutrophil count / lymphocyte count ratio, and systemic inflammation response index (SIRI)=neutrophil count×monocyte 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 (p<0.001). 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 (AUC=0.84; sensitivity=81.4%; specificity=79.2%, p<0.001) and osteoporosis from osteopenia (AUC=0.86; sensitivity=82.5%; specificity=78.6%; p<0.001). 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.
Keywords : emik Mineral Yoğunluğu, Hemodiyaliz, Osteoporoz, Sistemik Enflamasyon

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