C-reactive protein-to-lymphocyte ratio and trabecular bone score: A mediation analysis of BMI in the NHANES 2005 to 2008 cohort

Previous studies have focused on the relationship between C-reactive protein and Trabecular Bone Score (TBS), but the correlation between C-reactive protein-to-lymphocyte ratio (CLR) and TBS remains unclear. Some studies have shown that of body mass index (BMI) is associated with CLR and TBS, respectively. This study focused on the correlation between CLR and TBS and the mediating effect of BMI based on data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008. This study used data from the NHANES database (1789 males and 1699 females) to perform multivariate logistic regression, population characterization, and subgroup and interaction analyses to estimate the relationship between CLR and TBS, and explored the mediating role of BMI on the correlation between CLR and TBS through mediation analysis. A total of 3488 participants aged 20 years and older were recruited for this study. Multivariate regression analysis showed that those with a high CLR had a low TBS. Mediation analyses showed that CLR had a large direct effect on TBS (P < .0001) and that BMI partially mediated this relationship (55.2148%, P < .0001). This study found that increased levels of CLR were associated with decreased TBS and were influenced by BMI. CLR may be a valuable tool for assessing bone metabolism and deserves further exploration. These findings contribute to a deeper understanding of the impact of obesity on the lineage of the relationship between inflammation and bone health and provide new perspectives on the treatment and prevention of osteoporosis and osteoporotic fractures.