Skip to main content

Advertisement

Log in

The relationship between platelet count and bone mineral density: results from two independent population-based studies

  • Original Article
  • Published:
Archives of Osteoporosis Aims and scope Submit manuscript

Abstract

Summary

In two population-based study of middle-aged and older people, we investigated if platelet count was associated with bone mineral density and determined whether the association remained over time. Highest platelet counts within the normal range are significantly associated with osteopenia and osteoporosis in middle-aged and elderly people.

Purpose

Recently, platelets were found to play a role in bone remodeling. However, data on the association between platelet count and osteoporosis are lacking. Our study aimed to investigate the association between platelet counts, osteopenia, and osteoporosis in middle-aged and elderly Koreans.

Methods

We analyzed cross-sectional data from 5181 adults (postmenopausal women and men over 50 years of age) in the 2008–2011 Korea National Health and Nutrition Examination Survey (KNHANES) and longitudinal prospective data from 3312 adults over 50 years of age in the Korean Genome and Epidemiology Study (KoGES). Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry in the KNHANES and quantitative ultrasound in the KoGES. The platelet counts were categorized into quintiles within normal ranges (150–450 × 103 μL). The associations between platelet counts, osteopenia, and osteoporosis were estimated using a multinomial logistic model.

Results

BMD of the femur neck, total femur, and lumbar spine all decreased with increasing platelet counts. The cut-off points of the platelet counts to differentiate normal BMD from osteopenia and osteopenia from osteoporosis were 217 × 103/μL and 269 × 103/μL, respectively. The odds ratios (95% confidence intervals) in the highest platelet quartile were 1.39 (1.03–1.88) for osteopenia and 1.60 (1.07–2.37) for osteoporosis after adjusting for confounding factors. The distal radius T-score was significantly decreased in the highest platelet tertile group at a follow-up of 10 years.

Conclusion

Highest platelet counts within the normal range are significantly associated with osteopenia and osteoporosis in middle-aged and elderly people.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Raisz LG (2005) Pathogenesis of osteoporosis: concepts, conflicts, and prospects. J Clin Invest 115(12):3318–3325. https://doi.org/10.1172/jci27071

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. International Osteoporosis Foundation osteoporosis and musculoskeletal diseases. https://www.iofbonehealth.org

  3. Cheung CL, Ang SB, Chadha M, Chow ES, Chung YS, Hew FL, Jaisamrarn U, Ng H, Takeuchi Y, Wu CH, Xia W, Yu J, Fujiwara S (2018) An updated hip fracture projection in Asia: the Asian Federation of Osteoporosis Societies study. Osteoporos Sarcopenia 4(1):16–21. https://doi.org/10.1016/j.afos.2018.03.003

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ravindrarajah R, Hazra NC, Charlton J, Jackson SHD, Dregan A, Gulliford MC (2018) Incidence and mortality of fractures by frailty level over 80 years of age: cohort study using UK electronic health records. BMJ Open 8(1):e018836. https://doi.org/10.1136/bmjopen-2017-018836

    Article  PubMed  PubMed Central  Google Scholar 

  5. Linden MD, Jackson DE (2010) Platelets: pleiotropic roles in atherogenesis and atherothrombosis. Int J Biochem Cell Biol 42(11):1762–1766. https://doi.org/10.1016/j.biocel.2010.07.012

    Article  CAS  PubMed  Google Scholar 

  6. Koupenova M, Clancy L, Corkrey HA, Freedman JE (2018) Circulating platelets as mediators of immunity, inflammation, and thrombosis. Circ Res 122(2):337–351. https://doi.org/10.1161/circresaha.117.310795

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Samocha-Bonet D, Justo D, Rogowski O, Saar N, Abu-Abeid S, Shenkerman G, Shapira I, Berliner S, Tomer A (2008) Platelet counts and platelet activation markers in obese subjects. Mediat Inflamm 2008:834153. https://doi.org/10.1155/2008/834153

    Article  CAS  Google Scholar 

  8. Taniguchi A, Fukushima M, Seino Y, Sakai M, Yoshii S, Nagasaka S, Yamauchi I, Okumura T, Nin K, Tokuyama K, Yamadori N, Ogura M, Kuroe A, Nakai Y (2003) Platelet count is independently associated with insulin resistance in non-obese Japanese type 2 diabetic patients. Metabolism 52(10):1246–1249

    Article  CAS  Google Scholar 

  9. Jesri A, Okonofua EC, Egan BM (2005) Platelet and white blood cell counts are elevated in patients with the metabolic syndrome. J Clin Hypertens (Greenwich) 7(12):705–711 quiz 712-703

    Article  Google Scholar 

  10. Ly HQ, Kirtane AJ, Murphy SA, Buros J, Cannon CP, Braunwald E, Gibson CM (2006) Association of platelet counts on presentation and clinical outcomes in ST-elevation myocardial infarction (from the TIMI trials). Am J Cardiol 98(1):1–5. https://doi.org/10.1016/j.amjcard.2006.01.046

    Article  PubMed  Google Scholar 

  11. Ciovacco WA, Cheng YH, Horowitz MC, Kacena MA (2010) Immature and mature megakaryocytes enhance osteoblast proliferation and inhibit osteoclast formation. J Cell Biochem 109(4):774–781. https://doi.org/10.1002/jcb.22456

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Aguila HL, Rowe DW (2005) Skeletal development, bone remodeling, and hematopoiesis. Immunol Rev 208(1):7–18

    Article  CAS  Google Scholar 

  13. Li XS, Zhang JR, Meng SY, Li Y, Wang RT (2012) Mean platelet volume is negatively associated with bone mineral density in postmenopausal women. J Bone Miner Metab 30(6):660–665. https://doi.org/10.1007/s00774-012-0362-4

    Article  CAS  PubMed  Google Scholar 

  14. Yan P, Xu Y, Wan Q, Feng J, Yang J, Li H, Zhong H, Gao C, Zhang Z (2018) Impact of MPV and PDW on bone mineral density and their relationship with osteoporosis in Chinese patients with type 2 diabetes. Int J Clin Exp Med 11(3):2337–2349

    Google Scholar 

  15. Cure E, Balik MS, Cumhur Cure M, Guvercin Y, Erkut A, Yuce S, Keskin D (2013) Is the mean platelet volume predictive of hip fractures in the elderly? Ann Lab Med 33(5):367–370. https://doi.org/10.3343/alm.2013.33.5.367

    Article  PubMed  PubMed Central  Google Scholar 

  16. Akbal A, Gokmen F, Gencer M, Inceer BS, Komurcu E (2014) Mean platelet volume and platelet distribution width can be related to bone mineralization. Osteoporos Int 25(9):2291–2295. https://doi.org/10.1007/s00198-014-2764-8

    Article  CAS  PubMed  Google Scholar 

  17. Salari Sharif P, Abdollahi M (2010) The role of platelets in bone remodeling. Inflammation & Allergy-Drug Targets (Formerly Current Drug Targets-Inflammation & Allergy) 9(5):393–399

    Google Scholar 

  18. Pirsl F, Curtis LM, Steinberg SM, Tella SH, Katić M, Dobbin M, Hsu J, Hakim FT, Mays JW, Im AP, Pulanić D, Mitchell SA, Baruffaldi J, Masuch L, Halverson DC, Gress RE, Barsony J, Pavletic SZ (2016) Characterization and risk factor analysis of osteoporosis in a large cohort of patients with chronic graft-versus-host disease. Biol Blood Marrow Transplant 22(8):1517–1524. https://doi.org/10.1016/j.bbmt.2016.04.012

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kim Y, Han BG (2017) Cohort profile: the Korean genome and epidemiology study (KoGES) consortium. Int J Epidemiol 46(2):e20. https://doi.org/10.1093/ije/dyv316

    Article  PubMed  Google Scholar 

  20. Sempos CT, Vesper HW, Phinney KW, Thienpont LM, Coates PM (2012) Vitamin D status as an international issue: national surveys and the problem of standardization. Scand J Clin Lab Invest Suppl 243:32–40. https://doi.org/10.3109/00365513.2012.681935

    Article  CAS  PubMed  Google Scholar 

  21. Lewiecki EM, Gordon CM, Baim S, Leonard MB, Bishop NJ, Bianchi ML, Kalkwarf HJ, Langman CB, Plotkin H, Rauch F, Zemel BS, Binkley N, Bilezikian JP, Kendler DL, Hans DB, Silverman S (2008) International Society for Clinical Densitometry 2007 adult and pediatric official positions. Bone 43(6):1115–1121. https://doi.org/10.1016/j.bone.2008.08.106

    Article  PubMed  Google Scholar 

  22. Damilakis J, Papadokostakis G, Vrahoriti H, Tsagaraki I, Perisinakis K, Hadjipavlou A, Gourtsoyiannis N (2003) Ultrasound velocity through the cortex of phalanges, radius, and tibia in normal and osteoporotic postmenopausal women using a new multisite quantitative ultrasound device. Investig Radiol 38(4):207–211. https://doi.org/10.1097/01.rli.0000057031.21810.f4

    Article  Google Scholar 

  23. Krieg M-A, Barkmann R, Gonnelli S, Stewart A, Bauer DC, Barquero LDR, Kaufman JJ, Lorenc R, Miller PD, Olszynski WP (2008) Quantitative ultrasound in the management of osteoporosis: the 2007 ISCD official positions. J Clin Densitom 11(1):163–187

    Article  Google Scholar 

  24. Luo J, Xiong C (2013) Youden index and associated cut-points for three ordinal diagnostic groups. Commun Stat Simul Comput 42(6):1213–1234. https://doi.org/10.1080/03610918.2012.661906

    Article  PubMed  Google Scholar 

  25. Miyamoto K, Yoshida S, Kawasumi M, Hashimoto K, Kimura T, Sato Y, Kobayashi T, Miyauchi Y, Hoshi H, Iwasaki R, Miyamoto H, Hao W, Morioka H, Chiba K, Kobayashi T, Yasuda H, Penninger JM, Toyama Y, Suda T, Miyamoto T (2011) Osteoclasts are dispensable for hematopoietic stem cell maintenance and mobilization. J Exp Med 208(11):2175–2181. https://doi.org/10.1084/jem.20101890

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Aguila HL, Rowe DW (2005) Skeletal development, bone remodeling, and hematopoiesis. Immunol Rev 208:7–18. https://doi.org/10.1111/j.0105-2896.2005.00333.x

    Article  CAS  PubMed  Google Scholar 

  27. Vinholt PJ, Hvas AM, Frederiksen H, Bathum L, Jorgensen MK, Nybo M (2016) Platelet count is associated with cardiovascular disease, cancer and mortality: a population-based cohort study. Thromb Res 148:136–142. https://doi.org/10.1016/j.thromres.2016.08.012

    Article  CAS  PubMed  Google Scholar 

  28. Karolczak K, Soltysik B, Kostka T, Witas PJ, Watala C (2019) Platelet and red blood cell counts, as well as the concentrations of uric acid, but not homocysteinaemia or oxidative stress, contribute mostly to platelet reactivity in older adults. Oxidative Med Cell Longev 2019:9467562. https://doi.org/10.1155/2019/9467562

    Article  CAS  Google Scholar 

  29. Clowes JA, Riggs BL, Khosla S (2005) The role of the immune system in the pathophysiology of osteoporosis. Immunol Rev 208:207–227. https://doi.org/10.1111/j.0105-2896.2005.00334.x

    Article  CAS  PubMed  Google Scholar 

  30. Gravallese EM, Goldring SR, Schett G (2016) The role of the immune system in the local and systemic bone loss of inflammatory arthritis. In: Osteoimmunology. Elsevier, pp 241–256

  31. Lin CC, Li TC, Liu CS, Yang CW, Lin CH, Hsiao JH, Meng NH, Lin WY, Liao LN, Li CI, Wu FY (2016) Associations of TNF-alpha and IL-6 polymorphisms with osteoporosis through joint effects and interactions with LEPR gene in Taiwan: Taichung Community Health Study for Elders (TCHS-E). Mol Biol Rep 43(10):1179–1191. https://doi.org/10.1007/s11033-016-4037-4

    Article  CAS  PubMed  Google Scholar 

  32. Wu ZJ, He JL, Wei RQ, Liu B, Lin X, Guan J, Lan YB (2015) C-reactive protein and risk of fracture: a systematic review and dose-response meta-analysis of prospective cohort studies. Osteoporos Int 26(1):49–57. https://doi.org/10.1007/s00198-014-2826-y

    Article  CAS  PubMed  Google Scholar 

  33. Al-Daghri NM, Aziz I, Yakout S, Aljohani NJ, Al-Saleh Y, Amer OE, Sheshah E, Younis GZ, Al-Badr FB (2017) Inflammation as a contributing factor among postmenopausal Saudi women with osteoporosis. Medicine (Baltimore) 96(4):e5780. https://doi.org/10.1097/md.0000000000005780

    Article  Google Scholar 

  34. Maitz P, Kandler B, Fischer MB, Watzek G, Gruber R (2006) Activated platelets retain their potential to induce osteoclast-like cell formation in murine bone marrow cultures. Platelets 17(7):477–483. https://doi.org/10.1080/09537100600759105

    Article  CAS  PubMed  Google Scholar 

  35. Nakarai A, Kato J, Hiraoka S, Takashima S, Inokuchi T, Takahara M, Sugihara Y, Harada K, Okada H (2018) An elevated platelet count increases the risk of relapse in ulcerative colitis patients with mucosal healing. Gut Liver 12(4):420–425. https://doi.org/10.5009/gnl17236

    Article  PubMed  PubMed Central  Google Scholar 

  36. Zhou Q, Zhu L, Zhang D, Li N, Li Q, Dai P, Mao Y, Li X, Ma J, Huang S (2016) Oxidative stress-related biomarkers in postmenopausal osteoporosis: a systematic review and meta-analyses. Dis Markers 2016:7067984. https://doi.org/10.1155/2016/7067984

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Topaloglu N, Yildirim S, Tekin M, Kaymaz N, Tutunculer F, Ozdemir C, Cosar E (2014) Mean platelet volume and ischemia modified albumin levels in cord blood of infants of diabetic mothers. Pediatr Neonatol 55(6):455–458. https://doi.org/10.1016/j.pedneo.2014.02.002

    Article  PubMed  Google Scholar 

  38. Tsompos C, Panoulis C, Toutouzas K, Zografos G, Papalois A (2015) Antioxidant 21-aminosteroid "U-74389G" ameliorates the short-time effect of hypoxia-reoxygenation on the platelet count in rats. Folia Med Cracov 55(1):25–34

    PubMed  Google Scholar 

  39. Silvagno F, De Vivo E, Attanasio A, Gallo V, Mazzucco G, Pescarmona G (2010) Mitochondrial localization of vitamin D receptor in human platelets and differentiated megakaryocytes. PLoS One 5(1):e8670. https://doi.org/10.1371/journal.pone.0008670

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. D’Amelio P, Cristofaro MA, De Vivo E et al (2012) Platelet vitamin D receptor is reduced in osteoporotic patients. Panminerva Med 54(3):225–231

    PubMed  Google Scholar 

  41. Hans D, Baim S (2017) Quantitative ultrasound (QUS) in the management of osteoporosis and assessment of fracture risk. J Clin Densitom 20(3):322–333

    Article  Google Scholar 

Download references

Acknowledgments

Data in this study were from the KoGES 4851-302, National Research Institute of Health, Centers for Disease Control and Prevention, Ministry for Health and Welfare, Republic of Korea.

Funding

This study was financially supported by a 2018 faculty research grant from Yonsei University College of Medicine [6-2018-0090] to Yu-Jin Kwon.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Hye Sun Lee or Yu-Jin Kwon.

Ethics declarations

Conflicts of interest

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(PDF 132 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, J., Kim, H.S., Lee, H.S. et al. The relationship between platelet count and bone mineral density: results from two independent population-based studies. Arch Osteoporos 15, 43 (2020). https://doi.org/10.1007/s11657-020-0700-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11657-020-0700-4

Keywords

Navigation