Prognostic Nutritional Index in Patients with Both Vertebral and Non-Vertebral Osteoporotic Fractures

Objective: The prognostic nutritional index (PNI) is an index used to evaluate the basic nutritional status of patients with osteoporosis. However, it is not yet clear whether PNI can be used as an indicator of osteoporotic fracture. This study aimed to investigate whether the PNI is different in osteoporotic patients with and without fragility fractures. Materials and Methods: This retrospective study included 58 female patients with osteoporosis. The first group included 28 patients with osteoporotic fractures and 30 patients without fractures. The primary outcome measure was PNI calculated using albumin and lymphocyte values. The secondary outcome measures were bone mineral density (BMD), albumin, lymphocyte, calcium, phosphorus, alkaline phosphatase, parathyroid hormone, calcium/creatine ratio in spot urine, 25-hydroxy vitamin D values, and FRAX (R) scores. Results: The mean age and body mass index (BMI) were similar in both groups (1st group: age: 67.60 +/- 9.78 years; BMI: 27.63 +/- 3.89 kg/m2, 2nd group: age: 66.83 +/- 7.91 years; BMI: 27.04 +/- 4.50 kg/m2). Patients with fragility fractures had a significantly higher risk of FRAX (R) major osteoporotic fracture (p=0.002) and lower phosphorus levels (p=0.002). There were no significant differences in the PNI and blood albumin levels. Among patients with fragility fractures, albumin levels were significantly lower in patients with vertebral fractures (p=0.049), and corrected calcium values were significantly lower in patients with non-vertebral fractures (p=0.002). Correlation analysis showed that in patients with fragility fractures, there was no correlation between PNI, albumin levels, BMD, and FRAX (R). Conclusion: Our results showed no association between PNI and fragility fractures in patients with osteoporosis.