{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T06:48:32Z","timestamp":1765954112396,"version":"3.48.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the association between prealbumin levels and BMD among individuals aged 50 and above residing in southwestern China.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A case\u2013control study was conducted. A total of 534 individuals aged \u2265 50\u202fyears 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 \u2265 50\u202fyears according to the World Health Organization criteria, which recommends a T score \u2264\u202f\u2212\u202f2.5. Multivariable logistic regression was used to analyze the risk factors for osteoporosis, particularly the association between prealbumin levels and osteoporosis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 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 (\n p<\/jats:italic>\n \u202f&lt;\u202f0.05). Bivariate correlation analysis revealed that Hemoglobin A1c (\n r<\/jats:italic>\n \u202f=\u202f\u22120.287,\n p<\/jats:italic>\n \u202f&lt;\u202f0.01) was negatively correlated with BMD in participants, while albumin (\n r<\/jats:italic>\n \u202f=\u202f0.206,\n p<\/jats:italic>\n \u202f&lt;\u202f0.01), prealbumin (\n r<\/jats:italic>\n \u202f=\u202f0.292,\n p<\/jats:italic>\n \u202f&lt;\u202f0.01) and Hemoglobin (\n r<\/jats:italic>\n \u202f=\u202f0.255,\n p<\/jats:italic>\n \u202f&lt;\u202f0.01) were positively correlated with BMD. Multiple logistic regression analysis revealed prealbumin level as a significant determinant of decreased BMD (OR, odds ratio\u202f=\u202f2.317; 95% CI, confidence interval: 1.439\u20133.731;\n p<\/jats:italic>\n \u202f&lt;\u202f0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Our findings demonstrate that low prealbumin levels are significantly associated with an increased risk of osteoporosis among adults aged \u226550\u202fyears in southwestern China. Individuals with this risk factor should receive regular BMD monitoring and early targeted interventions to prevent osteoporosis.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2025.1695044","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T06:44:04Z","timestamp":1765953844000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between prealbumin levels and the risk of osteoporosis among individuals aged 50 and above in Southwest China: a retrospective case\u2013control study"],"prefix":"10.3389","volume":"12","author":[{"given":"Xu","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenhui","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaoqing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianming","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tongwei","family":"Chu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1651","DOI":"10.1007\/s00198-009-0925-y","article-title":"Osteoporosis 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Physician"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1007\/BF00296660","article-title":"Biochemical markers of nutrition in osteoporosis","volume":"52","author":"Rico","year":"1993","journal-title":"Calcif Tissue Int"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1016\/j.nut.2016.08.002","article-title":"Reduced prealbumin is associated with bone mineral density in women with osteoporosis","volume":"33","author":"Li","year":"2017","journal-title":"Nutrition"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"57361","DOI":"10.1177\/2040622319857361","article-title":"Association of serum prealbumin with risk of osteoporosis in older adults with type 2 diabetes mellitus: a cross-sectional study","volume":"10","author":"Xiu","year":"2019","journal-title":"Ther Adv Chronic Dis"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s12986-024-00865-1","article-title":"Gastrointestinal health and 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atherogenic index of plasma with bone mineral density: a cross-sectional study","volume":"23","author":"Xu","year":"2024","journal-title":"Lipids Health Dis"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s13018-025-05460-5","article-title":"Contradictory links between lipid levels and bone health: Atherogenic index of plasma and bone microarchitecture","volume":"20","author":"Xu","year":"2025","journal-title":"J Orthop Surg Res"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1007\/s00125-017-4269-4","article-title":"Diabetes, bone and glucose-lowering agents: basic biology","volume":"60","author":"Lecka-Czernik","year":"2017","journal-title":"Diabetologia"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"453","DOI":"10.7150\/ijms.8172","article-title":"Increased levels of circulating advanced glycation end-products in menopausal women with 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Med"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1566","DOI":"10.1515\/CCLM.2007.334","article-title":"The systemic inflammatory response syndrome C-reactive protein and transthyretin conundrum","volume":"45","author":"Bernstein","year":"2007","journal-title":"Clin Chem Lab Med"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e44552","DOI":"10.1371\/journal.pone.0044552","article-title":"Estrogen deficiency induces the differentiation of IL-17 secreting Th17 cells: a new candidate in the pathogenesis of osteoporosis","volume":"7","author":"Tyagi","year":"2012","journal-title":"PLoS One"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1177\/1721727X17739514","article-title":"IL-17 and VEGF are increased and correlated to systemic inflammation, immune suppression, and malnutrition in patients with breast cancer","volume":"15","author":"Tachibana","year":"2017","journal-title":"Eur J Inflamm"}],"container-title":["Frontiers in 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