The relationship between inflammation, osteoporosis, and sleep disturbances: a cross-sectional analysis

Abstract Background Inflammation is a crucial factor in the development of both osteoporosis and sleep disturbances; however, the mechanisms that connect these two conditions are not yet fully understood. This study aims to investigate the relationship among inflammation, osteoporosis, and sleep dis...

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Main Authors: Peng Gu, Xiyan Zhao, Zheng Zhang, Bao Zhang, Ying Du, Yanqing Jia, Hao Tang, Yi Wang, Tianlin Wen, Zhiwei Jia, Yaohong Wu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-025-02900-0
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author Peng Gu
Xiyan Zhao
Zheng Zhang
Bao Zhang
Ying Du
Yanqing Jia
Hao Tang
Yi Wang
Tianlin Wen
Zhiwei Jia
Yaohong Wu
author_facet Peng Gu
Xiyan Zhao
Zheng Zhang
Bao Zhang
Ying Du
Yanqing Jia
Hao Tang
Yi Wang
Tianlin Wen
Zhiwei Jia
Yaohong Wu
author_sort Peng Gu
collection DOAJ
description Abstract Background Inflammation is a crucial factor in the development of both osteoporosis and sleep disturbances; however, the mechanisms that connect these two conditions are not yet fully understood. This study aims to investigate the relationship among inflammation, osteoporosis, and sleep disturbances, and to assess whether osteoporosis acts as a mediating factor between inflammation and sleep disturbances. Methods This study conducted a cross-sectional analysis utilizing data from participants aged 50 and older, sourced from the NHANES database for the years 2005–2010 and 2017–2018. The primary objective was to investigate the associations among inflammatory markers, the Dietary Inflammatory Index (DII), osteoporosis, and sleep disturbances. All participants underwent measurement of inflammatory markers, including C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR). Additionally, DII scores were computed to assess dietary inflammation. To account for potential confounding variables, such as age, sex, and body mass index (BMI), we conducted multivariable regression analyses. Results The results demonstrated that the 'osteoporosis with sleep disturbances' group exhibited significantly higher CRP levels and DII scores but lower NLR levels compared to the 'without osteoporosis and sleep disturbances' group. Among the four groups, two groups without sleep disturbances showed notably lower CRP levels. After controlling for potential confounding variables, we found a positive correlation among inflammatory markers, osteoporosis, and sleep disturbances. Notably, sex (with males as the reference group) moderated the relationship between inflammatory markers and sleep disturbances, demonstrating an adjusted effect size of − 0.430 for NLR (interaction p value = 0.008) and − 0.163 for CRP (interaction p value = 0.012). Additionally, a non-linear relationship was observed between NLR and sleep disturbances, as well as between NLR, DII, and osteoporosis. Mediation analysis indicated that osteoporosis partially mediates the effect of DII on sleep disturbances, accounting for 5.4574% of the total effect (p = 0.002). Conclusions Men may exhibit a reduced resistance to inflammation-induced sleep disturbances in comparison to women. An increase in the DII may serve as a risk factor for both osteoporosis and sleep disturbances. Furthermore, osteoporosis partially mediates the relationship between the DII and sleep disturbances.
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spelling doaj-art-0fae9eaacbb94390adf5d4620db0ec9e2025-08-20T03:42:44ZengBMCEuropean Journal of Medical Research2047-783X2025-07-0130111110.1186/s40001-025-02900-0The relationship between inflammation, osteoporosis, and sleep disturbances: a cross-sectional analysisPeng Gu0Xiyan Zhao1Zheng Zhang2Bao Zhang3Ying Du4Yanqing Jia5Hao Tang6Yi Wang7Tianlin Wen8Zhiwei Jia9Yaohong Wu10Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical SciencesDepartment of Public Health, Qinghai University School of MedicineDepartment of Orthopedics, Guangyuan Central HospitalDepartment of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Spine Surgery, Ganzhou People’s HospitalAbstract Background Inflammation is a crucial factor in the development of both osteoporosis and sleep disturbances; however, the mechanisms that connect these two conditions are not yet fully understood. This study aims to investigate the relationship among inflammation, osteoporosis, and sleep disturbances, and to assess whether osteoporosis acts as a mediating factor between inflammation and sleep disturbances. Methods This study conducted a cross-sectional analysis utilizing data from participants aged 50 and older, sourced from the NHANES database for the years 2005–2010 and 2017–2018. The primary objective was to investigate the associations among inflammatory markers, the Dietary Inflammatory Index (DII), osteoporosis, and sleep disturbances. All participants underwent measurement of inflammatory markers, including C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR). Additionally, DII scores were computed to assess dietary inflammation. To account for potential confounding variables, such as age, sex, and body mass index (BMI), we conducted multivariable regression analyses. Results The results demonstrated that the 'osteoporosis with sleep disturbances' group exhibited significantly higher CRP levels and DII scores but lower NLR levels compared to the 'without osteoporosis and sleep disturbances' group. Among the four groups, two groups without sleep disturbances showed notably lower CRP levels. After controlling for potential confounding variables, we found a positive correlation among inflammatory markers, osteoporosis, and sleep disturbances. Notably, sex (with males as the reference group) moderated the relationship between inflammatory markers and sleep disturbances, demonstrating an adjusted effect size of − 0.430 for NLR (interaction p value = 0.008) and − 0.163 for CRP (interaction p value = 0.012). Additionally, a non-linear relationship was observed between NLR and sleep disturbances, as well as between NLR, DII, and osteoporosis. Mediation analysis indicated that osteoporosis partially mediates the effect of DII on sleep disturbances, accounting for 5.4574% of the total effect (p = 0.002). Conclusions Men may exhibit a reduced resistance to inflammation-induced sleep disturbances in comparison to women. An increase in the DII may serve as a risk factor for both osteoporosis and sleep disturbances. Furthermore, osteoporosis partially mediates the relationship between the DII and sleep disturbances.https://doi.org/10.1186/s40001-025-02900-0InflammationOsteoporosisSleep disturbancesC-reactive proteinNeutrophil-to-lymphocyte ratioDietary inflammatory index
spellingShingle Peng Gu
Xiyan Zhao
Zheng Zhang
Bao Zhang
Ying Du
Yanqing Jia
Hao Tang
Yi Wang
Tianlin Wen
Zhiwei Jia
Yaohong Wu
The relationship between inflammation, osteoporosis, and sleep disturbances: a cross-sectional analysis
European Journal of Medical Research
Inflammation
Osteoporosis
Sleep disturbances
C-reactive protein
Neutrophil-to-lymphocyte ratio
Dietary inflammatory index
title The relationship between inflammation, osteoporosis, and sleep disturbances: a cross-sectional analysis
title_full The relationship between inflammation, osteoporosis, and sleep disturbances: a cross-sectional analysis
title_fullStr The relationship between inflammation, osteoporosis, and sleep disturbances: a cross-sectional analysis
title_full_unstemmed The relationship between inflammation, osteoporosis, and sleep disturbances: a cross-sectional analysis
title_short The relationship between inflammation, osteoporosis, and sleep disturbances: a cross-sectional analysis
title_sort relationship between inflammation osteoporosis and sleep disturbances a cross sectional analysis
topic Inflammation
Osteoporosis
Sleep disturbances
C-reactive protein
Neutrophil-to-lymphocyte ratio
Dietary inflammatory index
url https://doi.org/10.1186/s40001-025-02900-0
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