Establishment and Validation of a Predictive Nomogram Model for Osteoporosis in Postmenopausal Women with Type 2...

To investigate the correlation between blood biomarkers and blood glucose fluctuations with the risk of osteoporosis (OP) in postmenopausal women with type 2 diabetes mellitus (T2DM), and to construct a predictive nomogram for OP.

Based on bone mineral density (BMD) results from dual-energy X-ray absorptiometry (DXA), participants were divided into OP (BMD T-value ≤ -2.5 SD) and Non-OP (BMD T-value > -2.5 SD) groups. Logistic analysis were used to explore the potential risk factors, following by the construction of a nomogram to predict the risk of OP. The discrimination and calibration of the nomogram were evaluated using concordance index (C-index), area under curve (AUC), and calibration curves.

We finally included 381 participants, with 147 in the OP group. Correlation analysis revealed a significant positive correlation between age and SII, and a negative correlation between BMI and CV. SII and CV demonstrated a positive dose-response relationship with OP, while FT3 exhibited a negative relationship. Multivariate logistic analysis showed that age (OR=1.088, 95% CI 1.052-1.125, P<0.001), BMI (OR=0.772, 95% CI 0.702-0.848, P<0.001), SII (OR=1.004, 95% CI 1.003-1.005, P<0.001), FT3 (OR=0.529, 95% CI 0.280-0.998, P=0.049), and CV (OR=1.051, 95% CI 1.007-1.097, P=0.022) were independent risk factors. The subgroup analysis showed the correlation between SII and OP occurred primarily in individuals aged ≥60 years. A predictive nomogram model was constructed based on age, BMI, SII, FT3, and CV, with a C-index of 0.842 (range 0.801-0.883). Decision Curve Analysis (DCA) demonstrated good clinical fit of the model.

SII can predict the OP occurrence in women aged ≥60 years, while FT3 is applicable for predicting OP in women aged ≥70 years and those with a BMI <24 kg/m². The predictive nomogram demonstrated great predictive value in postmenopausal women with T2DM.