Associations between systemic inflammation response index and femur bone mineral density in adults: The NHANES 2005–2010, 2013–2014, and 2017–2018

A unique measure of inflammatory evaluation, the systemic inflammation response index (SIRI) may offer useful data for the diagnosis and risk assessment of a number of diseases. The aim of this study was to investigate the relationship between SIRI and femur bone mineral density (BMD) in US adults. The association between SIRI and femur BMD was examined using multivariate logistic regression, sensitivity analysis, and smoothing curve fitting using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010, 2013–2014, and 2017–2018. Subgroup analysis and interaction tests were employed to examine the population-level stability of this connection. This present study included 18,022 participants older than 20 years from NHANES (2005–2010, 2013–2014, and 2017–2018). The present study showed a negative association between SIRI and femur BMD (including total femur BMD, femoral neck BMD, trochanter BMD, and intertrochanter BMD). In the fully adjusted model, we found a negative association between the SIRI and total femur BMD (Beta = −0.0032, 95% CI: −0.0053 to −0.0012), a negative association between the SIRI and femoral neck BMD (Beta = −0.0025, 95% CI: −0.0045 to −0.0005), a negative association between the SIRI and trochanter BMD (Beta = −0.0032, 95% CI: −0.0050 to −0.0013), a negative association between the SIRI and intertrochanter BMD (Beta = −0.0031, 95% CI: −0.0056 to −0.0007). This negative association was more pronounced in older adults > 65 years of age. In addition, we found a U-shaped association between SIRI and femur BMD by further smoothing curve-fitting methods. SIRI was negatively associated with femur BMD in US adults, and this association was more significant in older adults over 65 years. SIRI may be a useful, convenient, and practical indicator of inflammation. Moreover, older adults with high SIRI levels are likely to have low femur BMD.