{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:10:54Z","timestamp":1790345454636,"version":"4.1.0"},"reference-count":39,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82272535"],"award-info":[{"award-number":["82272535"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shanghai Sailing Program","award":["23YF1425900"],"award-info":[{"award-number":["23YF1425900"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the association between SIRI and spinal BMD and assess the influence of age, hypertension, and diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from 13,950 participants aged \u226520\u00a0years. SIRI was calculated using neutrophil, monocyte, and lymphocyte counts, and spinal BMD was measured by DXA. Linear regression, generalized additive models, and segmented regression were used, with subgroup analyses based on age, hypertension, and diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A threshold effect was observed at SIRI = 0.68. Below this threshold, SIRI negatively correlated with spinal BMD (\u03b2 = \u22120.0412,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0494), while above it, a positive correlation was found (\u03b2 = 0.0079,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). Subgroup analyses showed stronger positive associations in older adults (\u226565\u00a0years, \u03b2 = 0.0136,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001), and those with hypertension (\u03b2 = 0.0089,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0004) and diabetes (\u03b2 = 0.0187,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A segmented nonlinear relationship exists between SIRI and spinal BMD, with age, hypertension, and diabetes as significant modifiers. SIRI may serve as a biomarker for osteoporosis risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682251344593","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T10:42:03Z","timestamp":1747824123000},"page":"330-340","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Deciphering the Threshold and Segmented Nonlinear Association Between Systemic Inflammation Response Index and Spinal Bone Density: Insights From a Large-Scale Population Study"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9315-177X","authenticated-orcid":false,"given":"Muradil","family":"Mardan","sequence":"first","affiliation":[{"name":"Xinhua Hospital Affiliated to Shanghai Jiaotong University School of 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