Neutrophil-lymphocyte ratio may be superior to C-reactive protein for predicting the occurrence of postmenopausal osteoporosis

Yilmaz H., Uyfun M., Yilmaz T., Namuslu M., Inan O., Taskin A., ...More

Endocrine Regulations, vol.48, no.1, pp.25-33, 2014 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 48 Issue: 1
  • Publication Date: 2014
  • Doi Number: 10.4149/endo_2014_01_25
  • Journal Name: Endocrine Regulations
  • Journal Indexes: Scopus
  • Page Numbers: pp.25-33
  • Keywords: BMD, CRP, Inflammation, Menopause, NLR, Osteoporosis
  • Lokman Hekim University Affiliated: No


© 2014, Institute of Experimental Endocrinology. All rights reserved.Objective: Recent studies revealed that inflammation plays a critical role in bone remodeling and the pathogenesis of postmenopausal osteoporosis, a major health concern. Neutrophil-lymphocyte ratio (NLR) is a cost-effective marker of inflammation that has been linked with several diseases. This study aimed to compare NLR and C-reactive protein (CRP) levels in osteopenic, osteoporotic, and control subjects and to assess the correlation between NLR levels, CRP, and bone mineral density (BMD) in postmenopausal women. Methods: In this cross-sectional study, the relationship between NLR, CRP, and BMD in 438 women was investigated using uni- and multivariate analyses. BMD (g/cm²) was measured by dual-energy X-ray absorptiometry (DEXA) at the lumbar spine and femur. Complete blood count (CBC), CRP, glucose/lipid metabolism, and established risk factors were determined. Results: In the osteoporotic group, NLR and CRP levels were found to be elevated as compared to the osteopenic and control groups (NLR: 4.68 ± 0.72, 3.17 ± 0.43, 2.01 ± 0.54; CRP: 12.3 ± 4.1, 4.1 ± 2.7, 3.2 ± 2.1, respectively). A negative correlation was present between NLR and the lumbar spine (L2-L4) and femoral neck BMD after adjusting other risk factors. There was no correlation between CRP levels and BMD after adjusting other risk factors. NLR was significantly associated with L2-L4 BMD (ß = -0.653, p<0.001) and femoral neck BMD (ß = -0.178, p<0.001), but CRP level had no association with BMD in a multivariate model. Conclusions: Our data indicate that NLR may be a better predictor than CRP for occurrence of osteoporosis in postmenopausal women.