Abstract
BACKGROUND: Although the role of serum phosphorus in bone metabolism is well-established, its precise connection to bone density in different anatomical regions remains uncertain. The pelvis, a vital load-bearing structure crucial for movement and stability, has received limited attention because of its relationship with serum phosphorus. This study investigated the potential association between serum phosphorus levels and pelvic bone mineral density (BMD) in adults aged 18 to 59 years. METHODS: Using data from the 2015-2018 National Health and Nutrition Examination Surveys NHANES, we applied multivariable logistic regression models to investigate the association between serum phosphorus levels and pelvic BMD. The analysis was further refined using smoothed curves and generalized additive models. RESULTS: The analysis included a total of 5,589 adults. After adjusting for confounding variables, a negative association was observed between serum phosphorus levels and pelvic BMD. This inverse association was consistent in the subgroup analyses for females and Whites, however, this correlation was not found in males, Blacks, Mexican Americans, other Hispanics, or other racial groups. CONCLUSION: Our findings indicated a notable inverse association between serum phosphorus levels and pelvic bone mineral density in females, while no significant association was observed in males.