ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2026
The systemic inflammation response index is independently associated with incident fracture risk in older women.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Associations Between Peripheral Blood Inflammatory and Immune Markers and Osteoporotic and Fragility Fractures: A Systematic Review and Meta-Analysis.Calcified tissue international · 2026Pooled it
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6 authors.
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Abstract
This study investigated the link between the systemic inflammation response index (SIRI) and fracture risk in elderly women. Higher SIRI was associated with increased fracture risk, independent of clinical risk factors and bone mineral density, suggesting SIRI may be valuable for enhancing fracture risk assessment models. PURPOSE: The systemic inflammation response index (SIRI), including monocytes, neutrophils, and lymphocytes (SIRI = monocytes x neutrophils/lymphocytes), has been linked to various health outcomes, including osteoporosis. This study aimed to explore the association between SIRI and fracture risk in elderly women.
methodsIn a Swedish prospective cohort of 2965 women aged 75-80 years, baseline examinations included blood analyses, dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT), physical function tests, and questionnaires. Cox proportional hazards regression models were used to assess associations between SIRI and incident fracture risk.
resultsThe median follow-up time was 8 years (IQR 7.2-8.8), during which 230 hip fractures, 790 major osteoporotic fractures (MOF), and 1059 any type of fracture occurred. Higher SIRI was significantly linked to an increased risk of hip fracture (hazard ratio [HR] per 1 SD increase 1.18, 95% CI [1.07-1.32], p < 0.01), MOF (1.10 [1.03-1.18], p < 0.01), and any fracture (1.11 [1.05-1.17], p < 0.001) independent of age, BMI, clinical risk factors (CRFs), and femoral neck bone mineral density (FN BMD). SIRI was related to poorer physical function (timed up-and-go [TUG], 11.8%, p < 0.05, highest [Q5] compared to the lowest [Q1] quintile of SIRI) and lower activity levels (physical activity scale for the elderly [PASE], -28.8%, p < 0.05, Q5 vs. Q1). SIRI was positively associated with cortical porosity and trabecular number, but not with BMD measured by DXA.
conclusionSIRI was positively and independently associated with incident fracture risk. Further studies are needed to establish whether SIRI provides additional value beyond existing risk factors.
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