Study of Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio in Bone Health among Postmenopausal Women

BACKGROUND: Osteoporosis is a skeletal disorder with altered bone microarchitecture and risk of fractures. Factors such as hormonal imbalance, oxidative stress, and chronic inflammation have been implicated in the causation of osteoporosis. Neutrophil-to-lymphocyte ratio (NLR) and Platelet-to-lymphocyte ratio (PLR) may have a potential role in bone health assessment. OBJECTIVES: This study aims to determine the role of NLR and PLR in bone health among postmenopausal women. METHODOLOGY: This is a retrospective cross-sectional study done from August 2023 to February 2025. A total of 125 postmenopausal women were recruited in the study. They were grouped as osteoporosis, osteopenia, and normal based on T-scores. NLR and PLR were calculated from complete hemogram done within 6 months of the scan. The risk of fractures was assessed using the FRAX calculator. RESULTS: The median NLR was 2.43, 2.14, and 1.98, respectively, among osteoporosis, osteopenia, and normal BMD groups; P = 0.245. The median PLRs were 140.47, 114.72, and 136.65, respectively; P = 0.090. The median NLR and PLR in patients with high risk for major osteoporotic fracture were 1.97 and 116.72 (P = 0.462, 0.888), and in those with high risk for hip fracture, were 2.54 and 127.90 (P = 0.066, 0.350), respectively. There was no statistical difference noted in participants with or without fractures and diabetes status. CONCLUSION: The study concluded that the NLR and PLR ratios did not have any positive influence on BMD or fracture risk in our population. Diabetes status showed no influence on bone health with respect to the inflammatory parameters.