Predicting Osteoporosis in Elderly Cancer Patients Using the Modified Glasgow Prognostic Index

IntroductionOsteoporosis increases fracture risk and mortality, and cancer treatments worsen bone loss. Although mGPS is a common inflammatory-nutritional marker in oncology, its role in predicting osteoporosis is unknown.MethodsThis cross-sectional retrospective study analyzed 93 cancer patients aged ≥50 who underwent dual-energy X-ray absorptiometry (DXA) scans within a year of the first chemotherapy allocation. The results were categorized into groups regarding T-score as normal (T ≥ -1.0), osteopenia (-2.5 < T < -1.0), and osteoporosis (T ≤ -2). Patients were categorized based on mGPS and body mass index (BMI), and regression analysis was performed to identify predictors of osteoporosis in the lumbar spine, femur neck, and total femur.ResultsAmong the patients, 61.3% were female, the median age was 61 years, 41.9% had osteoporosis in the lumbar spine, and 49.5% had osteopenia in the femoral neck. A significant association was observed between BMI and osteoporosis, with higher BMI linked to lower osteoporosis prevalence, particularly in the femur regions (<i>P</i> < .03). There were no significant associations between bone density in the lumbar spine/femoral neck/total femur and age, gender, disease stage, type of chemotherapy, or BMI (all <i>P</i> values >.05). A significant association between mGPS and bone density was observed in the lumbar spine (<i>P</i> = .001) and femur total (<i>P</i> < .001). In the lumbar spine, patients with an mGPS score of 0 had the highest proportion of normal bone density (71.4%), while those with an mGPS score of 2 had a higher prevalence of osteoporosis (55.6%) (<i>P</i> = .001). In the femur total, 46.7% of patients with an mGPS score of 2 were classified with osteoporosis, compared to only 8.5% of those with an mGPS score of 0 (<i>P</i> < 001). Patients with an mGPS score of 2 were over six times more likely to have osteoporosis in the lumbar spine (OR = 6.25,<i>P</i> = 0.027). In the femur total, an mGPS score of 2 also significantly predicted osteoporosis (OR = 5.472, <i>P</i> = .013).ConclusionmGPS is a cost-effective and reliable tool for predicting osteoporosis in elderly cancer patients, enabling early interventions. Integrating it into routine assessments could enhance patient outcomes by addressing osteoporosis risk.