The study retrospectively analyzed 534 individuals aged ≥50 years who underwent DXA examination between 2018–2023 at the Second Affiliated Hospital of the Army Medical University in Southwest China[1]. Osteoporosis was defined according to the WHO criteria as a T-score ≤ −2.5 in persons aged ≥ 50 years[1]. From available medical records, they recorded prealbumin, albumin, hemoglobin A1c, ALP, AST, ALT, age, sex, BMI and lifestyle factors[1]. Univariate analysis showed significant differences between groups with and without osteoporosis in age, BMI, gender, type of residence, physical activity, prealbumin, albumin, hemoglobin and HbA1c (p < 0.05)[1]. Bivariate correlation showed a negative correlation between HbA1c and BMD (r = −0.287, p < 0.01) and positive correlations between albumin (r = 0.206, p < 0.01), prealbumin (r = 0.292, p < 0.01) and hemoglobin with BMD (p < 0.01)[1]. Multiple logistic regression identified low prealbumin as a significant independent determinant of reduced BMD with OR = 2.317 (95% CI 1.439–3.731; p < 0.05)[ 1 ]. The authors recommend regular BMD monitoring and early targeted interventions to prevent osteoporosis in individuals with this risk characteristic[1].