Clinical Report: Relationship of Neutrophil Percentage-to-Albumin Ratio with Bone Mineral Density

Overview

This study investigates the association between the neutrophil percentage-to-albumin ratio (NPAR) and bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM). Higher NPAR levels were found in individuals with osteoporosis, and NPAR was independently associated with osteoporosis and negatively correlated with BMD.

Background

Patients with type 2 diabetes mellitus (T2DM) are at an increased risk of osteoporosis and fragility fractures, despite often having normal or elevated bone mineral density (BMD). Chronic low-grade inflammation and nutritional imbalance are key mechanisms contributing to this risk.

Data Highlights

Key Findings

• NPAR levels were significantly higher in patients with osteoporosis (P = 0.004).
• NPAR was independently associated with osteoporosis (OR = 3.42, P = 0.034).
• Negative correlation between NPAR and femoral neck BMD (b = -0.08, P = 0.009).
• Negative correlation between NPAR and total hip BMD (b = -0.08, P = 0.020).
• NPAR demonstrated a modest discriminative ability for prevalent osteoporosis (AUC = 0.62, P = 0.004).

Clinical Implications

NPAR should be interpreted in combination with other clinical indicators for a comprehensive evaluation.

Conclusion

The study presents findings on the association between NPAR and osteoporosis risk among patients with T2DM.

Related Resources & Content

1. Frontiers in Endocrinology, 2026 -- Association Between Neutrophil Percentage-to-Albumin Ratio and Bone Mineral Density and Prevalent Osteoporosis in Patients with Type 2 Diabetes Mellitus
2. Frontiers in Endocrinology — Nonlinear relationship between serum ferritin and diabetic retinopathy in patients with type 2 diabetes mellitus: mediating role of neutrophil-to-albumin ratio
3. Frontiers in Endocrinology — Body composition-derived principal components partially explain sex and age effects on bone mineral density in type 2 diabetes mellitus
4. The Journal of Clinical Endocrinology & Metabolism — Bone Microstructure in Elderly Men with Type 2 Diabetes: Significance of Bone Dimensions
5. Frontiers in Endocrinology — Baseline serum metabolites predict fractures in individuals who were Black and had type 2 diabetes
6. American Diabetes Association’s Standards of Care in Diabetes—2026
7. Recommendation: Osteoporosis to Prevent Fractures: Screening | United States Preventive Services Taskforce
8. Association between type 2 diabetes and site‐specific fracture risk: A systematic review and meta‐analysis of cohort studies including over 13 million participants - PMC
9. Association of type 2 diabetes with osteoporosis and fracture risk: A systematic review and meta-analysis - PMC
10. Advanced glycation end-products and sclerostin are elevated across diabetes phenotypes and associated with vertebral fractures in type 2 diabetes | BMC Endocrine Disorders | Springer Nature Link
11. To explore the association between the neutrophil percentage to albumin ratio and low bone mineral density/osteoporosis based on NHANES 2011–2018 | Scientific Reports
12. Neutrophil percentage to albumin ratio predicts all-cause and cardiovascular mortality in patients with diabetes or prediabetes from NHANES 1999–2018 | Scientific Reports
13. Frontiers | Association Between Neutrophil Percentage-to-Albumin Ratio and Bone Mineral Density and Prevalent Osteoporosis in Patients with Type 2 Diabetes Mellitus