Meta-Analysis of Platelet-to-Lymphocyte Ratio and Vertebral Fracture Risk

Seven observational studies were included in a systematic review and meta-analysis evaluating the association between platelet-to-lymphocyte ratio (PLR) and vertebral fracture risk in osteoporosis patients. The analysis synthesized categorical odds ratios (OR) and continuous standardized mean differences (SMD) from studies published up to July 2025. It found significantly higher vertebral fracture risk in high-PLR groups and higher PLR levels in fracture groups, though sensitivity analyses indicated result instability.

Use Cases

• Calculate pooled odds ratios (OR) from categorical data to quantify vertebral fracture risk in high-PLR patient groups.
• Compute standardized mean differences (SMD) from continuous PLR data to compare levels between fracture and non-fracture cohorts.
• Perform sensitivity analyses to identify sources of heterogeneity, such as specific studies like Di et al., 2024.
• Assess publication bias for the synthesized OR and SMD metrics from the included observational studies.

Strengths

• Includes data from 7 observational studies, providing a quantitative synthesis of findings.
• Reports specific statistical metrics: an OR of 1.02 (95% CI: 1.00, 1.03) and an SMD of 1.78 (95% CI: 0.32, 3.25).
• Follows a systematic review protocol registered with PROSPERO (CRD420251137240).

Limitations

• Small evidence base of only 7 included studies, limiting statistical power and generalizability.
• Sensitivity analyses revealed instability in both categorical and continuous outcome measures.
• Identified significant heterogeneity among study designs, with specific studies being primary sources.

Provenance

Source

Systematic search of PubMed, Embase, Web of Science, Cochrane, Wanfang, and CNKI databases.

Collection Method

Systematic review and meta-analysis following PRISMA guidelines, using Review Manager 5.4 and STATA 15.0 for data synthesis.

Time Range

Literature search covered studies published up to July 2025.

Freshness

Literature search was current up to July 2025; the record was last updated in March 2026.

Geography

Studies were sourced from international databases; specific geographic focus of included studies is not detailed.