The study retrospectively analyzed 2135 inpatients with osteoporotic fractures admitted to Kunshan Hospital from 2017–2023[1]. The exposure was serum creatinine and the outcome measure was the systemic inflammatory index SIRI; covariates such as age, sex, BMI, hypertension, diabetes, heart disease, chronic kidney disease, alcohol, smoking, phosphate, total cholesterol, triglycerides, and AST were included in the models[1]. After multivariate adjustment, serum creatinine was independently and positively associated with SIRI (β = 0.013; 95% CI 0.004–0.021; p < 0.01)[1]. Analysis using general additive models revealed a significant threshold (non-linear) effect with an inflection at 78 μmol/L creatinine (LRT p = 0.02)[1]. For creatinine values above 78 μmol/l, the association was stronger: each 1 μmol/l increase in creatinine was correlated with a 0.033 increase in SIRI (β = 0.033; 95% CI 0.014–0.052; p < 0.01)[1]. The authors suggest monitoring creatinine, inflammatory status, and renal function in hospitalized patients with OPF and note that these findings require confirmation in prospective studies[1].