Abstract
BACKGROUND: Suboptimal nutritional status has been significantly correlated with the risk of osteoporosis in postmenopausal women. Low prealbumin levels are considered independent factors associated with decreased bone mineral density (BMD). However, most studies were conducted exclusively on postmenopausal women. Therefore, further investigations are warranted to determine the extent to which these findings can be extrapolated to the male and general population. OBJECTIVE: To investigate the association between prealbumin levels and BMD among individuals aged 50 and above residing in southwestern China. METHODS: A case-control study was conducted. A total of 534 individuals aged ≥ 50 years who underwent dual-energy X-ray absorptiometry scanning between 2018 and 2023 at the Second Affiliated Hospital of the Army Medical University were included in this study. Prealbumin levels; hemoglobin A1c levels; alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase levels; age; sex; body mass index; and lifestyle factors were recorded by reviewing medical records. We defined osteoporosis in individuals aged ≥ 50 years according to the World Health Organization criteria, which recommends a T score ≤ - 2.5. Multivariable logistic regression was used to analyze the risk factors for osteoporosis, particularly the association between prealbumin levels and osteoporosis. RESULTS: A total of 534 participants who met the inclusion criteria were recruited. Univariate analysis revealed statistically significant differences in age, body mass index, sex, type of current residence, physical activity, prealbumin, albumin, hemoglobin levels, and Hemoglobin A1c levels (p < 0.05). Bivariate correlation analysis revealed that Hemoglobin A1c (r = -0.287, p < 0.01) was negatively correlated with BMD in participants, while albumin (r = 0.206, p < 0.01), prealbumin (r = 0.292, p < 0.01) and Hemoglobin (r = 0.255, p < 0.01) were positively correlated with BMD. Multiple logistic regression analysis revealed prealbumin level as a significant determinant of decreased BMD (OR, odds ratio = 2.317; 95% CI, confidence interval: 1.439-3.731; p < 0.05). CONCLUSION: Our findings demonstrate that low prealbumin levels are significantly associated with an increased risk of osteoporosis among adults aged ≥50 years in southwestern China. Individuals with this risk factor should receive regular BMD monitoring and early targeted interventions to prevent osteoporosis.