{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T19:44:47Z","timestamp":1776887087058,"version":"3.51.2"},"reference-count":44,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Serum albumin and the prognostic nutritional index (PNI), based on albumin and lymphocytes, are markers of nutritional and inflammatory status and have been associated with frailty and adverse outcomes in older adults. However, their relationship with fracture risk and underlying mechanisms remains unclear. In this prospective cohort study, 2966 community-dwelling Swedish women aged 75-80\u00a0yr were followed for a median of 8.0\u00a0yr. At baseline, blood samples were collected, BMD was assessed using DXA, and bone microarchitecture and composition were evaluated by HR-pQCT. Fractures were verified through regional X-ray archives, and injurious falls and mortality were obtained from registers. Physical function was assessed using standardized tests. Cox proportional hazards models and competing risk analyses were applied. PNI was defined as PNI\u2009=\u2009serum albumin (g\/L)\u2009+\u20095\u2009\u00d7\u2009total lymphocyte count (109\/L). In total, 229 hip fractures, 789 major osteoporotic fractures (MOF), 1059 fractures of any kind, 499 injurious falls, and 551 deaths occurred. Lower albumin and PNI were independently associated with increased risk of MOF (HR per 1 SD decrease: 1.13 [95% CI 1.06-1.22] and 1.18 [1.05-1.31], respectively; both p\u2009&amp;lt;\u2009.01) and any fracture (HR 1.12 [1.05-1.19] and 1.17 [1.07-1.29], respectively; both p\u2009&amp;lt;\u2009.01), even after adjustment for clinical risk factors, FN BMD and physical function. Albumin, and to a lesser extent PNI, was consistently associated with better physical function and lower risk of injurious falls and mortality. No significant associations were found between albumin or PNI and DXA-derived BMD, and only limited and inconsistent associations with HR-pQCT parameters. In conclusion, serum albumin and PNI independently predicted fracture risk in elderly women; however, the underlying mechanisms remain to be elucidated. Future studies should explore its contribution to fracture prediction models.<\/jats:p>","DOI":"10.1093\/jbmr\/zjag063","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T11:40:58Z","timestamp":1775043658000},"source":"Crossref","is-referenced-by-count":0,"title":["Serum albumin and the prognostic nutritional index independently predict fracture risk in elderly women"],"prefix":"10.1093","author":[{"given":"Raju","family":"Jaiswal","sequence":"first","affiliation":[{"name":"Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]},{"name":"Department of Research, Development, Education and Innovation, Sahlgrenska University Hospital , 413 45 Gothenburg ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berit A M","family":"Larsson","sequence":"additional","affiliation":[{"name":"Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]},{"name":"N\u00e4rh\u00e4lsan Sisj\u00f6n Health Centre , 436 32 Sisj\u00f6n ,","place":["Sweden"]},{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0323-1061","authenticated-orcid":false,"given":"Maria","family":"\u00c5berg","sequence":"additional","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]},{"name":"Regionh\u00e4lsan , 405 44 Gothenburg ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Johansson","sequence":"additional","affiliation":[{"name":"Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]},{"name":"Department of Orthopedic Surgery, Sahlgrenska University Hospital , 431 80 M\u00f6lndal ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4118-6038","authenticated-orcid":false,"given":"Kristian F","family":"Axelsson","sequence":"additional","affiliation":[{"name":"Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]},{"name":"N\u00e4rh\u00e4lsan Norrmalm Health Centre , 549 40 Sk\u00f6vde 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