Association between serum albumin with geriatric nutritional risk index and osteopenia in Chinese elderly men: a nested case-control study

Background and Objectives: Malnutrition is associated with a higher risk of osteoporosis. We aim to assess the relationship between serum albumin with geriatric nutritional risk index and osteopenia in Chinese elderly men. Methods and Study Design: This is a nested case-control study from a prospective cohort enrolled 1109 individuals who were followed for seven years. Demographic data, medical history, signs and symptoms, and laboratory parameters were collected and analysed. Nutritional status and Geriatric Nutritional Risk Index (GNRI) were assessed. The nutrition-related indexes predictive value for osteopenia development was analyzed through multivariate Cox regression analysis and by creating a receiver operating characteristic curve (ROC), calculating the area under the curve (AUC). Kaplan-Meier (K-M) method was further used to find the nutritional status level in the elderly men. Results: The ALB and GNRI correlated with the risk of osteopenia in Chinese elderly men. After adjusting for all covariates, people with higher ALB level (HR: 0.821; 95% CI: 0.790-0.852) and higher GNRI score (HR: 0.889; 95% CI: 0.869-0.908) had a smaller risk of osteopenia. ROC analysis showed that the AUC for ALB was 0.729 (p˂0.05) and for the GNRI score was 0.731 (p˂0.05). K-M curve indicated a significant difference in ALB level (p˂0.001) and GNRI score (p˂0.001) in the respective subgroups. Conclusions: This study found that lower ALB level and lower GNRI score are associated with a higher prevalence of osteopenia among elderly men in China.