Evaluation of inflammatory and cardiovascular-related indices as potential markers for postmenopausal osteoporosis-a...

Emerging evidence suggests a strong pathophysiological link between osteoporosis (OP), characterized by low bone mineral density (BMD), and cardiovascular disease. Biomarkers such as the atherogenic index of plasma (AIP) and the triglyceride-glucose (TyG) index, while primarily linked to cardiovascular risk, may also reflect the metabolic dysregulation seen in OP. Similarly, inflammatory markers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and neutrophil-monocyte ratio (NMR), along with ratios like lymphocyte/HDL-C, monocyte/HDL-C, and granulocyte/HDL-C have been suggested as potential diagnostic tools. The aim of this study was to evaluate the diagnostic discrimination of these accessible biomarkers for postmenopausal OP.

A retrospective analysis was performed on 387 postmenopausal women who underwent bone densitometry between 2021 and 2025. Data on body mass index (BMI), T-scores, age, menopause duration, and relevant laboratory parameters were collected. Inflammatory and biochemical indices were calculated using established formulas.

Age and menopause duration were significantly higher in the OP group compared to the normal and osteopenia groups (p < 0.01). Conversely, the median femoral neck T-score (FN-T) was significantly lower in the OP group. Among the biomarkers, only the monocyte/HDL-C ratio was significantly lower in the OP group (p < 0.05). Receiver operating characteristic (ROC) analysis indicated poor diagnostic discrimination for the monocyte/HDL-C ratio (AUC: 0.608), while all other biomarkers were non-significant (AUC < 0.6).

Even the statistically significant monocyte/HDL-C ratio failed to achieve clinically acceptable discriminatory ability. Consequently, these biomarkers cannot be recommended as standalone screening tools for postmenopausal osteoporosis.