The Correlation Between Neutrophil/Lymphocyte Ratio And Osteoporosis In Hypertensive Postmenopausal Women

Objective:In this study,we aimed to investigate the association of the neutrophil/lymphocyte ratio(NLR)with osteoporosis in hypertensive postmenopausal women.Materials and Methods:A cross-sectional study was conducted on 673 postmenopausal women aged 45 to 84 who underwent physical examination at the physical examination center of the First Affiliated Hospital of Fujian Medical University from January 2018 to March2018.They were divided into hypertensive(n = 167)and non-hypertensive groups(n= 506).General data,time from the menopause and body mass index(BMI)of the patients were recorded.The whole blood cell count was detected,white blood cell classification was counted,and the NLR was calculated.BMD values of the lumbar spine(LS),the femoral neck(FN)and the total hip(TH)were measured by Dual-Energy X-ray Absorptiometry(DEXA).Propensity Score Matching(PSM)was used to match the confounding variables affecting BMD values.Bivariate correlation analysis was used to explore the relationship between NLR and BMD,and multiple logistic regression analysis was used to further examine the risk factors for osteoporosis.Results:After PSM,there was no significant difference between the hypertensive group(n = 103)and the non-hypertensive group(n = 103)in baseline characteristics,including age,BMI and the time from the menopause([59.88 ± 6.62] VS [59.28 ±6.91],[21.82 ± 2.12] VS [22.12 ± 1.83],[10.95 ± 8.07] VS [9.46 ± 7.25];P > 0.05).Compared with the non-hypertensive group,hypertensive group had significantly lower BMD at the LS,FN and TH([0.97 ± 0.15] VS [1.05 ± 0.16],[0.85 ± 0.13] VS[0.90 ± 0.13],[0.93 ± 0.13] VS [0.97 ± 0.13];P < 0.05),and significantly higher rates of osteoporosis(27.2% ± 13.6%,P < 0.05).The hypertension group and the non-hypertension group were further divided into three subgroups respectively:osteoporosis,osteopenia and normal bone mass.The analysis indicated that NLR in the osteoporosis subgroup of the hypertension group was significantly higher than that in the osteopenia subgroup and normal bone mass subgroup([2.24 ± 0.90] VS [1.61± 0.51] VS [1.68 ± 0.55],P < 0.05).But this phenomenon was not observed in the non-hypertensive group([2.05 ± 0.88] VS [1.59 ± 0.50] VS [1.58 ± 0.59],P > 0.05).In addition,the hypertensive patients were further stratified into two subgroups based on the median of NLR(NLR = 1.64)as a cut-off value,which showed that the BMD in the NLR-high group(NLR ≥ 1.64)were lower than those in the NLR-low group([0.94 ± 0.15] VS [1.00 ± 0.14],[0.82 ± 0.14] VS [0.88 ± 0.11],[0.90 ± 0.13] VS[0.96 ± 0.12],P < 0.05).Bivariate correlation analysis demonstrated that NLR was negatively correlated with BMD of the FN(r =-0.238,P = 0.016)and the TH(r =-0.204,P = 0.038).Multiple logistic regression analysis showed that NLR was significantly positively correlated with osteoporosis after adjusting for age and BMI factors(Odds ratio = 1.229,95%CI [1.018 1.483],P = 0.032),suggesting that NLR was an independent risk factor for osteoporosis.Conclusion:NLR is negatively correlated with BMD in postmenopausal women with hypertension,and NLR is a risk factor for osteoporosis.With the increasing of NLR,it is more likely to occur bone loss,BMD decreasing,and the increasing incidence of osteoporosis.Therefore,NLR can be used as a biomarker of osteoporosis in hypertensive postmenopausal women,which is an early warning of osteoporosis.