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Osteoporosis is often under diagnosed, under treated and imposed a considerable economic burden on the health system. About two fifth of the post-menopausal women of Bangladesh are affected. Early diagnosis is necessary to halt the disease process. Serum osteocalcin, neutrophil-lymphocyte ratio (NLR) increases and bone mineral density (BMD) decreases in osteoporosis. There is no specific diagnostic test for osteoporosis except BMD. It is costly, has radiation hazard and not available in all laboratories in our country. On the other hand, serum osteocalcin and NLR are easily available and a promising marker which can be done as routine blood test for the diagnosis of osteoporosis.  Objective: The objective of the study was to evaluate the association of serum osteocalcin and NLR with BMD for the diagnosis of osteoporosis.  Materials and methods: This cross-sectional study was conducted in the Department of Laboratory Medicine and the Department of Orthopedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) from March, 2020 to February, 2021. A total 50 diagnosed patient of osteoporosis, who fulfil the inclusion and exclusion criteria were selected as study population. They were grouped as normal, osteopenia and osteoporosis according to T-score of BMD report. Serum osteocalcin and NLR evaluated from routine blood test. Statistical analysis was done by statistical package for social science (SPSS) software windows version 22.  Results: Negative Pearson’s correlation was found between serum osteocalcin with T-score of BMD (r=-0.812, p=0.002) and between NLR with T-score of BMD (r=-0.826, p=0.001). In receiver operating characteristic (ROC) curve analysis, cut off value of serum osteocalcin was 18.65 ng/mL having sensitivity 67.0% and specificity 70.0% with a cut off value of NLR was 4.54 with sensitivity 72.0% and specificity 75.0%.   Conclusion: Serum osteocalcin and NLR has significant negative correlation with T-score of BMD. Because of high sensitivity and specificity, serum osteocalcin and NLR may be used to diagnosis of osteoporosis

Association of Serum Osteocalcin and Neutrophil-Lymphocyte Ratio with Bone Mineral Density for the Diagnosis of Osteoporosis