Association between systemic inflammation response index and osteoporosis in perimenopausal and postmenopausal women:...

This study aimed to analyze the risk factors of osteoporosis in perimenopausal and postmenopausal women, especially the correlation between inflammatory indicators and osteoporosis and construct a risk prediction model for osteoporosis. A total of 299 perimenopausal and postmenopausal women (40-60 years old) were enrolled from September 2023 to September 2025, who underwent physical examination or hospitalization at the Affiliated Hospital of Binzhou Medical University. They were stratified into 3 groups based on lumbar spine (L1-L4) bone mineral density measurements: normal bone mass group (n = 112), osteopenia group (n = 105), and osteoporosis group (n = 82). General clinical data, laboratory indicators, and composite inflammatory markers - including the systemic inflammation response index (SIRI), systemic immune-inflammation index, and neutrophil-to-lymphocyte ratio - were collected. Spearman correlation analysis, univariate/multivariate logistic regression analyses, and LASSO regression analysis were performed. An osteoporosis risk nomogram was constructed, and the clinical assessment utility for evaluating the association with osteoporosis was assessed using the receiver operating characteristic curve (ROC). Significant differences in age, body mass index, diabetes history, neutrophils, and lymphocytes were noted among the 3 groups (all P < .05). SIRI was negatively correlated with bone mineral density (r = -0.203, P < .001) and positively correlated with osteoporosis (r = 0.273, P < .001). Multivariate logistic regression confirmed SIRI as an independent risk factor for osteoporosis after adjusting for confounding variables (OR = 5.841, 95% CI: 2.721-12.541, P < .001). The area under the receiver operating characteristic curve of SIRI for predicting osteoporosis was 0.677. Meanwhile, the combined model (SIRI + diabetes history + age + low-density lipoprotein cholesterol + history of frequent falls) achieved a significantly higher area under the curve of 0.802 (P < .001). SIRI is significantly associated with osteoporosis in perimenopausal and postmenopausal women, providing potential clinical reference value for risk assessment. The combined assessment model incorporating age, low density lipoprotein cholesterol, diabetes history, and history of frequent falls can enhance clinical assessment utility for evaluating the association with osteoporosis.