Inflammation-related composite indices and their association with osteoporosis and fragility fractures in rheumatoid arthritis
Authors' conclusion
Novel composite inflammatory indices, particularly CLR and IBI, are associated with low bone density and fragility fracture history.
Study context
- Population
- Patients with rheumatoid arthritis (RA), stratified by bone mineral density (BMD)
- Participants
- 439 patients
- Exposure
- CRP-to-lymphocyte ratio (CLR) vs Inflammation Burden Index (IBI)
- Outcome
- Association of composite:
- Inflammatory indices with osteoporosis
- Fracture history
Main finding
As reported in the abstract
Discrimination of osteoporosis (ROC analysis)
| Group | AUC |
|---|---|
| CLR | 0.607 (95% CI: 0.554-0.660) |
| IBI | 0.591 (95% CI: 0.537-0.64) |
AUC
CLR0.607 (95% CI: 0.554-0.660)
IBI0.591 (95% CI: 0.537-0.64)
- Osteoporosis prevalence
- 55.4%
- Inflammatory gradient across BMD categories; CLR and IBI showed a more robust increase than conventional markers
- P for trend < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | CLR | IBI |
|---|---|---|
| Discrimination of fracture history (ROC analysis)Modest predictive value | ||
| AUC | 0.593 (95% CI: 0.532-0.655) | 0.581 (95% CI: 0.519-0.643) |
- Discrimination of fracture history (ROC analysis) — Fracture history in the osteoporosis group
- 41.2%
Discrimination of fracture history (ROC analysis)
- Markedly elevated CLR and IBI levels in patients with fracture history
Original publication
Inflammation-related composite indices and their association with osteoporosis and fragility fractures in rheumatoid arthritis. Arthritis Res Ther. Published 9 April 2026. doi:10.
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