Abstract
BACKGROUND: Osteoporosis (OP) is a metabolic bone disorder that is of significant concern to the elderly. However, few studies have investigated the correlation between the serum uric acid to creatinine ratio (UA/Cr) and OP in elderly individuals. This research seeks to examine the connection between UA/Cr levels and OP in older adults. METHODS: Data on participant information for the study was obtained from four cycles of the NHANES database. Multivariable logistic regression was employed to examine the correlation between UA/Cr and OP, adjusting for potential confounders such as age, gender, and race. The diagnostic efficacy of UA/Cr for OP was evaluated utilizing ROC curves. RESULTS: Multivariable logistic regression analysis showed that serum UA/Cr levels were significantly lower in individuals with OP than in those without OP. (OR = 0.83 [0.76, 0.91], P < 0.001). Subgroup analyses indicated a stronger association in men (OR = 0.77 [0.64, 0.94], P = 0.009) and women (OR = 0.85 [0.76, 0.95], P < 0.003). Furthermore, multivariable logistic regression analyses by ethnicity revealed that this association was significant solely among Non-Hispanic Whites (OR = 0.78 [0.68, 0.90], P < 0.001). The area under the ROC curve (AUC) for UA/Cr in predicting OP was higher than that for SUA alone, indicating superior predictive value. CONCLUSION: A higher UA/Cr level within the normal range is associated with a lower risk of OP, providing insights for its diagnosis and risk assessment.