AB1222 NEUTROPHIL TO LYMPHOCYTE RATIO (NLR) PREDICTS FRACTURE IN PATIENTS ON LONG-TERM GLUCOCORTICOID.

Background Long-term glucocorticoid (GC) exposure leads to systemic bone loss and fracture. In addition, GC is known increase white blood cell (WBC) amount change the distribution of differential count (DC). Neutrophil-to-Lymphocyte ratio (NLR) has been studied as an optimal marker subclinical inflammation, predicting prognosis cardiovascular diseases, cancers even covid-19 infection. For patients under long-term exposure, hemogram might be a potential parameter predict prognosis. Objectives This pilot study aims investigate if related WBC-DC change, including NLR, associated with future fractures during 3 years follow-up. Methods retrospective based on registry, conducted in Kaohsiung Chang Gung Memorial Hospital, Taiwan, from September 2014 till April 2021, aimed monitor mineral density (BMD) changes autoimmune diseases. All recruited were followed at least took X-ray images annually capture new fragility fracture, morphometric vertebral fractures. We screened participants who used continuously months before index day. recorded complete (CBC) values twice period after day, excluded febrile, infection status, diagnosed or diseases The NLR was calculated by absolute neutrophil divided lymphocyte individually. Results A total 346 enrolled current study, 101 (29.2%) suffered fracture years. Among non-fracture, conventional risk factors, such age, BMD, previous remained significantly different, while WBC revealed no difference (Table 1). Nevertheless, higher lower group, respectively, monocyte, eosinophil, basophil count. compared different ratio, providing odds 1.24 (95% confidence interval 1.07-1.44, p=0.005). Figure 1 showed that observed raised increased. Conclusion GC, helpful indicates risks. 1. Observed rate baseline Table Demographic characteristics glucocorticoid. Fracture N=101 No-Fracture N=245 p-value Age 63.7 ± 9.0 56.5 9.6 <0.001* Sex(women) 89(88.1) 210(85.7) 0.55 BMI 24.1 3.9 23.4 0.14 Previous 64(63.4) 55(22.4) Total hip BMD 0.738 0.133 0.790 0.122 0.001* Femoral neck 0.575 0.113 0.626 0.109 Lumbar 0.841 0.200 0.855 0.150 0.49 7.3 2.1 6.9 ±1.7 Hemoglobin 12.8 1.5 12.9 1.4 0.33 Platelet 239.2 64.7 247.9 71.4 0.30 Neutrophil 67.3 9.7 64.3 0.009* Lymphocyte 24.3 8.7 26.6 9.5 0.04* Monocyte 6.2 1.8 6.3 1.6 0.52 Eosinophil 1.9 1.3 0.77 Basophil 0.4 0.2 0.18 (Neutrophil lymphocyte) 3.3 1.7 2.8 0.004* NMR monocyte) 11.9 4.5 11.0 3.6 LMR (Lymphocyte 4.2 0.20 Acknowledgements work supported funding grant CMRPG8J0331 Hospital ( https://www.cgmh.org.tw ). Disclosure Interests None Declared.