Association between the nutritional risk index and postmenopausal osteoporosis in patients with type 2 diabetes...

To investigate the association between the Geriatric Nutritional Risk Index (GNRI) and the presence of postmenopausal osteoporosis (PMOP) in elderly female patients with type 2 diabetes mellitus (T2DM), and to evaluate the discriminatory ability of GNRI for PMOP in this population.

A retrospective observational study was conducted, enrolling 324 postmenopausal female patients with T2DM who were hospitalized at our hospital from September 2021 to November 2024. Participants were divided into an osteoporosis group (T-score ≤ - 2.5, n = 141) and a non-osteoporosis group (T-score > - 2.5, n = 183) based on lumbar spine bone mineral density (BMD) measured by dual-energy X-ray absorptiometry. Data on age, body mass index (BMI), BMD, serological indicators, and GNRI were collected and compared between the two groups. Correlation analysis was performed to examine the relationship between GNRI and various parameters. Binary logistic regression was used to identify independent factors influencing PMOP. The predictive efficacy of GNRI was assessed using the receiver operating characteristic (ROC) curve.

Compared to the non-osteoporosis group, patients in the osteoporosis group were significantly older and had significantly lower levels of GNRI, BMI, lumbar spine T-score, total protein, albumin, uric acid, albumin-corrected calcium, serum phosphorus, and 25-hydroxyvitamin D (all p < 0.05). Correlation analysis revealed that GNRI was negatively correlated with age (rs = -0.203, p < 0.001) and positively correlated with lumbar spine T-score (rs = 0.485, p < 0.001), albumin-corrected calcium (rs = 0.532, p < 0.001), and 25-hydroxyvitamin D (rs = 0.528, p < 0.001). Multivariate logistic regression analysis identified age as an independent risk factor for PMOP (OR = 1.092, 95% CI: 1.038-1.149, p = 0.001), while GNRI was independently associated with a lower risk of PMOP (OR = 0.812, 95% CI: 0.680-0.969, p = 0.021). ROC curve analysis demonstrated that the area under the curve (AUC) for GNRI in discriminating PMOP was 0.769 (95% CI: 0.718-0.820, p < 0.001). The optimal cut-off value was 101.2, with a sensitivity of 70.2% and a specificity of 73.8%.

In postmenopausal female patients with T2DM, a higher GNRI value is independently associated with a lower risk of PMOP. GNRI demonstrates moderate discriminatory ability for identifying PMOP in this population and may serve as a simple and useful auxiliary indicator for assessing skeletal health risk in clinical practice, pending further prospective validation.