Association between fibrinogen-to-albumin ratio and bone metabolism markers (β-CTX and P1NP) in Chinese individuals with osteoporotic fracture: a cross-sectional investigation

Abstract Objective Research on the link between inflammatory indicators and markers of bone metabolism is currently lacking, especially the interaction between Procollagen type 1 N-terminal propeptide (P1NP), the β-C-terminal telopeptide of type 1 collagen (β-CTX), and the fibrinogen-to-albumin rati...

Full description

Saved in:
Bibliographic Details
Main Authors: Li-long Feng, Ke Lu, Chong Li, Min-zhe Xu, Yao-wei Ye, Yi Yin, Hui-qiang Shan
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12891-025-08276-w
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832595029423554560
author Li-long Feng
Ke Lu
Chong Li
Min-zhe Xu
Yao-wei Ye
Yi Yin
Hui-qiang Shan
author_facet Li-long Feng
Ke Lu
Chong Li
Min-zhe Xu
Yao-wei Ye
Yi Yin
Hui-qiang Shan
author_sort Li-long Feng
collection DOAJ
description Abstract Objective Research on the link between inflammatory indicators and markers of bone metabolism is currently lacking, especially the interaction between Procollagen type 1 N-terminal propeptide (P1NP), the β-C-terminal telopeptide of type 1 collagen (β-CTX), and the fibrinogen-to-albumin ratio (FAR). This study intends to fill that knowledge gap by investigating the possible link between inflammatory indicators and bone metabolism. Methods This observational study included 718 individuals diagnosed with osteoporotic fractures from Kunshan Hospital Affiliated to Jiangsu University between January 2017 and July 2022. After accounting for several confounders, the independent connection between FAR levels and β-CTX and P1NP was investigated via Generalized Estimating Equations (GEE). On top of that, we used a generalized additive model (GAM) to find any non-linear correlations, and a two-piecewise linear regression model to find the threshold effects in the smoothing curves that came out of it. To ensure the aforementioned result was stable, a subgroup analysis was carried out. Results The results showed a positive linear correlation between FAR and β-CTX [β = 1.077, 95% confidence interval (CI): 0.24 to 1.92, P = 0.012]. The study’s findings demonstrated that FAR and P1NP fit curves in an inverted U-shaped pattern, and an inflection point K = 0.0685 for FAR was detected. P1NP showed a positive correlation with FAR below the inflection point (β = 306.10, 95% CI: 47.37 to 564.83, P = 0.021), and a negative correlation with FAR beyond the inflection point (β = -117.57, 95% CI: -231.34 to -3.80, P = 0.043). The subgroup analysis revealed that women had a more significant association between FAR and β-CTX in women than in men. Conclusions The results provide useful insights into the potential association between FAR and markers of bone metabolism. The study may provide a novel clinical implication by introducing FAR as a potential reference indicator for assessing bone health, offering a cost-effective and conveniently obtainable biomarker to monitor inflammation to improve bone metabolism in the treatment of osteoporosis.
format Article
id doaj-art-267e697f7422452ba3de7b70ee0949e5
institution Kabale University
issn 1471-2474
language English
publishDate 2025-01-01
publisher BMC
record_format Article
series BMC Musculoskeletal Disorders
spelling doaj-art-267e697f7422452ba3de7b70ee0949e52025-01-19T12:04:33ZengBMCBMC Musculoskeletal Disorders1471-24742025-01-012611910.1186/s12891-025-08276-wAssociation between fibrinogen-to-albumin ratio and bone metabolism markers (β-CTX and P1NP) in Chinese individuals with osteoporotic fracture: a cross-sectional investigationLi-long Feng0Ke Lu1Chong Li2Min-zhe Xu3Yao-wei Ye4Yi Yin5Hui-qiang Shan6Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu UniversityDepartment of Orthopedics, Affiliated Kunshan Hospital of Jiangsu UniversityDepartment of Orthopedics, Affiliated Kunshan Hospital of Jiangsu UniversityDepartment of Orthopedics, Affiliated Kunshan Hospital of Jiangsu UniversityDepartment of Orthopedics, Affiliated Kunshan Hospital of Jiangsu UniversityDepartment of Orthopedics, Affiliated Kunshan Hospital of Jiangsu UniversityDepartment of Orthopedics, Affiliated Kunshan Hospital of Jiangsu UniversityAbstract Objective Research on the link between inflammatory indicators and markers of bone metabolism is currently lacking, especially the interaction between Procollagen type 1 N-terminal propeptide (P1NP), the β-C-terminal telopeptide of type 1 collagen (β-CTX), and the fibrinogen-to-albumin ratio (FAR). This study intends to fill that knowledge gap by investigating the possible link between inflammatory indicators and bone metabolism. Methods This observational study included 718 individuals diagnosed with osteoporotic fractures from Kunshan Hospital Affiliated to Jiangsu University between January 2017 and July 2022. After accounting for several confounders, the independent connection between FAR levels and β-CTX and P1NP was investigated via Generalized Estimating Equations (GEE). On top of that, we used a generalized additive model (GAM) to find any non-linear correlations, and a two-piecewise linear regression model to find the threshold effects in the smoothing curves that came out of it. To ensure the aforementioned result was stable, a subgroup analysis was carried out. Results The results showed a positive linear correlation between FAR and β-CTX [β = 1.077, 95% confidence interval (CI): 0.24 to 1.92, P = 0.012]. The study’s findings demonstrated that FAR and P1NP fit curves in an inverted U-shaped pattern, and an inflection point K = 0.0685 for FAR was detected. P1NP showed a positive correlation with FAR below the inflection point (β = 306.10, 95% CI: 47.37 to 564.83, P = 0.021), and a negative correlation with FAR beyond the inflection point (β = -117.57, 95% CI: -231.34 to -3.80, P = 0.043). The subgroup analysis revealed that women had a more significant association between FAR and β-CTX in women than in men. Conclusions The results provide useful insights into the potential association between FAR and markers of bone metabolism. The study may provide a novel clinical implication by introducing FAR as a potential reference indicator for assessing bone health, offering a cost-effective and conveniently obtainable biomarker to monitor inflammation to improve bone metabolism in the treatment of osteoporosis.https://doi.org/10.1186/s12891-025-08276-wProcollagen type 1 N-terminal propeptide (P1NP)Osteoporotic fractureFibrinogen-to-albumin ratio (FAR)Inflammatory markersBone metabolism markersβ-C-terminal telopeptide of type 1 collagen (β-CTX)
spellingShingle Li-long Feng
Ke Lu
Chong Li
Min-zhe Xu
Yao-wei Ye
Yi Yin
Hui-qiang Shan
Association between fibrinogen-to-albumin ratio and bone metabolism markers (β-CTX and P1NP) in Chinese individuals with osteoporotic fracture: a cross-sectional investigation
BMC Musculoskeletal Disorders
Procollagen type 1 N-terminal propeptide (P1NP)
Osteoporotic fracture
Fibrinogen-to-albumin ratio (FAR)
Inflammatory markers
Bone metabolism markers
β-C-terminal telopeptide of type 1 collagen (β-CTX)
title Association between fibrinogen-to-albumin ratio and bone metabolism markers (β-CTX and P1NP) in Chinese individuals with osteoporotic fracture: a cross-sectional investigation
title_full Association between fibrinogen-to-albumin ratio and bone metabolism markers (β-CTX and P1NP) in Chinese individuals with osteoporotic fracture: a cross-sectional investigation
title_fullStr Association between fibrinogen-to-albumin ratio and bone metabolism markers (β-CTX and P1NP) in Chinese individuals with osteoporotic fracture: a cross-sectional investigation
title_full_unstemmed Association between fibrinogen-to-albumin ratio and bone metabolism markers (β-CTX and P1NP) in Chinese individuals with osteoporotic fracture: a cross-sectional investigation
title_short Association between fibrinogen-to-albumin ratio and bone metabolism markers (β-CTX and P1NP) in Chinese individuals with osteoporotic fracture: a cross-sectional investigation
title_sort association between fibrinogen to albumin ratio and bone metabolism markers β ctx and p1np in chinese individuals with osteoporotic fracture a cross sectional investigation
topic Procollagen type 1 N-terminal propeptide (P1NP)
Osteoporotic fracture
Fibrinogen-to-albumin ratio (FAR)
Inflammatory markers
Bone metabolism markers
β-C-terminal telopeptide of type 1 collagen (β-CTX)
url https://doi.org/10.1186/s12891-025-08276-w
work_keys_str_mv AT lilongfeng associationbetweenfibrinogentoalbuminratioandbonemetabolismmarkersbctxandp1npinchineseindividualswithosteoporoticfractureacrosssectionalinvestigation
AT kelu associationbetweenfibrinogentoalbuminratioandbonemetabolismmarkersbctxandp1npinchineseindividualswithosteoporoticfractureacrosssectionalinvestigation
AT chongli associationbetweenfibrinogentoalbuminratioandbonemetabolismmarkersbctxandp1npinchineseindividualswithosteoporoticfractureacrosssectionalinvestigation
AT minzhexu associationbetweenfibrinogentoalbuminratioandbonemetabolismmarkersbctxandp1npinchineseindividualswithosteoporoticfractureacrosssectionalinvestigation
AT yaoweiye associationbetweenfibrinogentoalbuminratioandbonemetabolismmarkersbctxandp1npinchineseindividualswithosteoporoticfractureacrosssectionalinvestigation
AT yiyin associationbetweenfibrinogentoalbuminratioandbonemetabolismmarkersbctxandp1npinchineseindividualswithosteoporoticfractureacrosssectionalinvestigation
AT huiqiangshan associationbetweenfibrinogentoalbuminratioandbonemetabolismmarkersbctxandp1npinchineseindividualswithosteoporoticfractureacrosssectionalinvestigation