{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:24:24Z","timestamp":1790717064765,"version":"4.1.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The intricate relationship between systemic immune-inflammation index (SII) and trimethylamine N-oxide (TMAO) in the peripheral blood and osteoporosis (OP) remains unclear. This study aims to investigate variations in the levels of SII and TMAO in the peripheral blood of overweight and obese patients, and examine the associations between these markers, bone mineral density (BMD), and the occurrence of osteoporotic fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study enrolled 765 patients aged \u2265 50 years with BMI \u2265 24 kg\/m\u00b2, dividing them into two groups based on visceral fat area (VFA): &amp;lt;100 cm\u00b2 and \u2265100 cm\u00b2. A corrected regression model analyzed the association of SII, TMAO, BMD, and osteoporotic fractures incidence in patients with central obesity. Receiver operator characteristic (ROC) curves assessed the predictive ability of SII and TMAO for OP screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline data showed that patients with VFA \u2265 100 cm\u00b2 had lower whole body (WB) and lumbar spine (LS) BMD, but higher SII and TMAO levels compared to those with VFA &amp;lt; 100 cm\u00b2 (p &amp;lt; 0.05). Particularly in the group with VFA \u2265 100 cm<jats:sup>2<\/jats:sup>, there was an upward trend in SII and TMAO as bone mass decreased. Regression analysis found SII and TMAO negatively correlated with WB, LS, and femoral neck (FN) BMD, and positively correlated with osteoporotic fractures incidence (p &amp;lt; 0.05). Both were independent risk factors for OP, with combined SII and TMAO detection showing high diagnostic efficacy (sensitivity 94.7%, specificity 96.5%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In overweight and obese patients, particularly those with a VFA \u2265 100 cm\u00b2, peripheral blood SII and TMAO levels may serve as valuable biomarkers for the early diagnosis of OP, offering potential clinical utility in identifying high-risk individuals.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1539594","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T05:14:09Z","timestamp":1739423649000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Association between systemic immune-inflammation index and trimethylamine N-oxide levels in peripheral blood and osteoporosis in overweight and obese 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