Endocrinology and Metabolism

Review Article

Mineral, bone & muscle
Complete Blood Count Parameters and Bone Health: Clinical and Experimental Evidence: Jeonghoon Ha, Mayo Ono, Hui Zhu, Caroline Cencer, Xiyu Ge, Joy Y. Wu; Endocrinol Metab. 2025;40(6):811-820. Published online December 3, 2025; DOI: https://doi.org/10.3803/EnM.2025.2695

2,257 View
90 Download
2 Web of Science
2 Crossref

Osteoporotic fractures pose a significant burden in aging populations, yet current assessment strategies may overlook systemic factors influencing bone health. Emerging evidence suggests that complete blood count (CBC) parameters, including red blood cell indices, white blood cell (WBC) counts and subtypes, and platelet counts, are associated with skeletal fragility and fracture risk. Anemia has been consistently linked to reduced bone mineral density and increased fracture susceptibility, potentially due to impaired oxygen delivery and osteoblast dysfunction. Elevated red cell distribution width may reflect oxidative stress and has been associated with bone loss. Inflammatory markers such as high WBC count and neutrophil-to-lymphocyte ratio are implicated in enhanced osteoclast activity, while platelet abnormalities may influence bone remodeling and fracture healing. These associations suggest that CBC-derived markers could serve as accessible and cost-effective indicators to support osteoporosis evaluation. However, important limitations remain, including undefined clinical thresholds, limited longitudinal evidence, and uncertain causality. Further research is needed to clarify underlying mechanisms and determine whether correcting hematological abnormalities can improve skeletal outcomes. A cautious, evidence-based approach is warranted to define the role of CBC parameters in the clinical assessment of bone health.

Citations

Citations to this article as recorded by

Complete Blood Count Parameters and Bone Health: Clinical and Experimental Evidence (Endocrinol Metab 2025;40:811-20, Jeonghoon Ha et al.)
Federica Tramontana, Richard Quinton
Endocrinology and Metabolism.2026; 41(2): 333. CrossRef
Complete Blood Count Parameters and Bone Health: Clinical and Experimental Evidence (Endocrinol Metab 2025;40:811-20, Jeonghoon Ha et al.)
Jeonghoon Ha, Joy Y. Wu
Endocrinology and Metabolism.2026; 41(2): 335. CrossRef

Original Article

Clinical Study
Association between Serum Free Thyroxine and Anemia in Euthyroid Adults: A Nationwide Study: Mijin Kim, Bo Hyun Kim, Hyungi Lee, Min Hee Jang, Jeong Mi Kim, Eun Heui Kim, Yun Kyung Jeon, Sang Soo Kim, In Joo Kim; Endocrinol Metab. 2020;35(1):106-114. Published online March 19, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.1.106

11,912 View
168 Download
6 Web of Science
7 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background

Studies on the relationship between thyroid function and anemia in the euthyroid range are scarce. We aimed to evaluate the association between anemia and serum free thyroxine (fT4) and thyrotropin (TSH) in euthyroid adults.

Methods

Data on 5,352 participants aged ≥19 years were obtained from the Korea National Health and Nutrition Examination Survey VI (2013 to 2015). Anemia was defined as hemoglobin (Hb) <13 and <12 g/dL for men and women, respectively.

Results

Overall, 6.1% of participants had anemia, and more women (9.9%) had anemia than men (2.8%, P<0.001). In multivariate analysis, serum fT4 levels, but not TSH, were positively associated with serum Hb levels in both sexes (P<0.001, each). Serum Hb levels linearly reduced across decreasing serum fT4 quartile groups in both sexes (P<0.001, each). After adjusting for potential confounding factors, participants with low-normal fT4 had 4.4 (P=0.003) and 2.8 times (P<0.001) higher risk for anemia than those with high-normal fT4 among men and women, respectively. When participants were divided into two groups at 50 years of age, in younger participants, men and women with the first quartile were at higher risk of anemia than men with the second quartile (odds ratio [OR], 3.3; P=0.029) and women with the forth quartile (OR, 3.2; P<0.001), respectively. This association was not observed in older participants.

Conclusion

These results suggest that a low-normal level of serum fT4 was associated with a lower serum Hb level and a higher risk of anemia in euthyroid adults, especially in younger participants.

Citations

Citations to this article as recorded by

A Prospective Study on Anemia in Hypothyroidism and Hyperthyroidism
U. P. Santosh, Priyanka Rajesh, Ajay S. Kumar, Ima Chandra, Veena Prabhakaran, Arfan Nasser
Indian Journal of Otolaryngology and Head & Neck Surgery.2025; 77(2): 779. CrossRef
Investigation of Hemoglobin, Iron, Ferritin, and Vitamin B12 Levels in Patients with Primary Hypothyroidism
Burcu Güler, Tijen Acar
Konuralp Tip Dergisi.2025; 17(3): 281. CrossRef
Thyroid Function and Risk of Anemia: A Multivariable-Adjusted and Mendelian Randomization Analysis in the UK Biobank
Nicolien A van Vliet, Annelies E P Kamphuis, Wendy P J den Elzen, Gerard J Blauw, Jacobijn Gussekloo, Raymond Noordam, Diana van Heemst
The Journal of Clinical Endocrinology & Metabolism.2022; 107(2): e643. CrossRef
Thyroid function, pernicious anemia and erythropoiesis: a two-sample Mendelian randomization study
Alisa D Kjaergaard, Alexander Teumer, Eirini Marouli, Panos Deloukas, Aleksander Kuś, Rosalie Sterenborg, Bjørn O Åsvold, Marco Medici, Christina Ellervik
Human Molecular Genetics.2022; 31(15): 2548. CrossRef
Changes of hematological indices in patients with diffuse toxic goiter
F. H. Saidova, L. M. Ahmedova, Zh. B. Aslanova, N. A. Najafov
Klinicheskaia khirurgiia.2021; 88(3-4): 76. CrossRef
Association between Serum Free Thyroxine and Anemia in Euthyroid Adults: A Nationwide Study (Endocrinol Metab 2020;35:106-14, Mijin Kim et al.)
Zheng Feei Ma
Endocrinology and Metabolism.2020; 35(2): 484. CrossRef
Association between Serum Free Thyroxine and Anemia in Euthyroid Adults: A Nationwide Study (Endocrinol Metab 2020;35:106-14, Mijin Kim et al.)
Mijin Kim, Bo Hyun Kim
Endocrinology and Metabolism.2020; 35(3): 669. CrossRef

Case Report

A Case of 45,X Turner's Syndrome with Iron Deficiency Anemia due to Menometrorrhagia and Spontaneous Sexual Development.: Mi Kwang Kwon, Suk Chon, Gwan Pyo Koh, Seung Jun Oh, Jeong Taek Woo, Sung Woon Kim, Jin Woo Kim, Young Seol Kim; J Korean Endocr Soc. 2005;20(2):160-167. Published online April 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.2.160

3,632 View
33 Download
1 Crossref

Abstract PDF

Short stature and gonadal dysgenesis are two characteristic clinical features of Turners syndrome. Very rarely, patients with Turners syndrome may menstruate and even be fertile. We experienced a case of Turners syndrome with spontaneous sexual development and menstruation. A 16-year-old girl was referred for severe anemia and menometrorrahgia. She had nearly normal features, with the exception of a short stature and a single right kidney. Also, she had spontaneous development of secondary sexual characteristics. We performed and anemia study and evaluated her short stature. In chromosomal study of her bone marrow and peripheral blood lymphocytes, she was revealed to have monosomy 45,X. Herein, this case is reported, with a brief review of literature

Citations

Citations to this article as recorded by

Spontaneous Sexual Development and Heavy Menstrual Bleeding in 45,X Monosomy and 45,X/47,XXX Mosaic Turner Syndrome and a Review of the Literature
Myeong Jin Kim, Hwal Rim Jeong
Journal of Pediatric and Adolescent Gynecology.2020; 33(5): 602. CrossRef

First
Prev
Page of 1
Next
Last

Search