The predictive role of monocyte-lymphocyte ratio and plateletlymphocyte ratio in postmenopausal osteoporosis

Objective. To investigate the relationship between neutrophil to lymphocyte ratio (NEU/LY), monocyte to lymphocyte ratio (MO/LY), platelet to lymphocyte ratio (PLT/LY), mean platelet volume to lymphocyte ratio (MPV/LY), mean platelet volume to platelet ratio (MPV/PLT), plateletcrit to platelet ratio (PCT/PLT) and postmenopausal osteoporosis. Materials and Methods. The data of the patients who were admitted to Ümraniye Training and Research Hospital between January 2017 and July 2020 and had both bone mineral densitometry and hemogram tests on the same day were retrospectively scanned. A number of 177 patients who had been in natural menopause for at least one year and did not have any chronic disease nor used any medication were first divided into 3 groups: a number of 48 patients with osteoporosis, 103 with osteopenia and 26 patients included in the control group. Later on, 177 patients were divided into two groups: 151 patients with low bone mineral density and 26 patients were included in the control group. Results. There was no difference between the three groups in terms of NEU/LY, MPV/LY, MPV/PLT and PCT/PLT. The MO/LY ratio and PLT/LY ratio were statistically significantly higher in the osteoporosis group (p = 0.002, p <0.001, respectively). The MO/LY ratio was significantly higher in the group with low bone mineral density compared to the control group (p = 0.011), while there was no statistical difference between the two groups in terms of PLT/LY ratio (p = 0.281). Conclusions. This study shows that MO/LY and PLT/LY are quite simple and cheap markers that can be used in the diagnosis of postmenopausal osteoporosis and MO/LY in the diagnosis of postmenopausal low bone mineral density.

Assessment of Low Bone Mineral Density in Untreated Patients with Takayasu’s Arteritis

Chronic inflammation affects bone metabolism and accelerates bone loss. This study is aimed at analyzing the prevalence of low bone mineral density (LBMD) in patients with untreated Takayasu’s arteritis (TA) and risk factors. Forty untreated TA patients were enrolled, including 38 premenopausal women and 2 men before 50 years old. The control group included 60 age- and gender-matched healthy persons. Bone mineral density (BMD) of lumbar vertebrae and hip in patients with TA and the control group was measured by the dual-energy X-ray method. Serum 25OHD and β-CTX were also measured. The lumbar BMD of TA patients ( 0.89 ± 0.11 g/cm2) was significantly lower than that of the healthy control ( 0.97 ± 0.11 g/cm2). The prevalence of LBMD at the lumbar spine (17.50%) was significantly higher than that of the control group (3.33%). However, there was no significant difference at the hip. The 25OHD of TA patients was lower than that of healthy controls, while the level of β-CTX was higher. The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in patients with LBMD were higher than those in patients with normal BMD. According to univariate correlation analysis, there was a significant negative correlation between LDL-C and lumbar BMD. Binary logistic regression analysis showed that LDL-C was an important factor affecting the occurrence of LBMD in patients with TA ( OR = 25.269 , P = 0.02 ). Our result reveals bone loss in TA patients, which hints the relationship among inflammation, lipid metabolism, and bone metabolism.

Serum Metabolite Profile Associated with Sex-Dependent Visceral Adiposity Index and Low Bone Mineral Density in a Mexican Population

Recent evidence shows that obesity correlates negatively with bone mass. However, traditional anthropometric measures such as body mass index could not discriminate visceral adipose tissue from subcutaneous adipose tissue. The visceral adiposity index (VAI) is a reliable sex-specified indicator of visceral adipose distribution and function. Thus, we aimed to identify metabolomic profiles associated with VAI and low bone mineral density (BMD). A total of 602 individuals from the Health Workers Cohort Study were included. Forty serum metabolites were measured using the targeted metabolomics approach, and multivariate regression models were used to test associations of metabolomic profiles with anthropometric, clinical, and biochemical parameters. The analysis showed a serum amino acid signature composed of glycine, leucine, arginine, valine, and acylcarnitines associated with high VAI and low BMD. In addition, we found a sex-dependent VAI in pathways related to primary bile acid biosynthesis, branched-chain amino acids, and the biosynthesis of pantothenate and coenzyme A (CoA). In conclusion, a metabolic profile differs by VAI and BMD status, and these changes are gender-dependent.

Low bone mineral density on DXA and slipped capital femoral epiphysis as rare presentation in a child with Rubinstein-Taybi syndrome

We present a 7-year-old girl with Rubinstein-Taybi syndrome (RTS) and slipped capital femoral epiphysis (SCFE). She underwent bilateral arthroscopy with implant fixation for the SCFE and the symptoms resolved. This was followed by fracture of the femur after minor trauma. Dual energy X-ray absorptiometry (DXA) scan done to evaluate her bone health revealed a low bone mineral density (BMD). Our case highlights the finding of low BMD on DXA and rare association of SCFE in a child with RTS. The conundrum in this case is whether this child can be labelled to have osteoporosis as defined by the criteria given by the International Society for Clinical Densitometry guidelines.