ArticleBMC geriatrics2026
Development and validation of an osteoporosis risk-assessment model for Chinese older adults: a large-scale retrospective study.
Article in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo identify the determinants of osteoporosis (OP) among older adults in China and develop a nomogram-based risk-assessment tool for clinical screening.
methodsWe retrospectively enrolled 8,243 consecutive older adults who underwent routine physical examinations at the Health Management Center of the First Affiliated Hospital of the University of Science and Technology of China between January 2023 and June 2025. After classifying participants into OP (n = 4,302) and non-OP (n = 3,941) groups according to bone mineral density measurements, we collected baseline demographic information, clinical history, and routine biochemical indices. Variables selection were selected via LASSO regression; subsequently, multivariable logistic regression was applied to identify independent risk factors for OP. A screening nomogram was constructed from these variables and internally validated through 1,000-replicate bootstrapping; discrimination (ROC curve), calibration (Hosmer–Lemeshow test and calibration plot), and clinical utility (decision curve analysis [DCA]) were assessed.
resultsMultivariable analysis revealed that female sex, increasing age, diabetes mellitus, and prior fracture history were independently associated with higher odds of OP (OR > 1 and all P < 0.05). Conversely, higher body mass index (BMI), serum uric acid, serum calcium and vitamin D levels were linked to reduced odds (OR < 1 and all P < 0.05). The nomogram achieved an AUC of 0.799 (95% CI: 0.789–0.808); calibration plots aligned closely with the ideal line (Hosmer–Lemeshow P = 0.796), while DCA indicated net clinical benefit between risk thresholds of 13% and 89%. After bootstrapping, the AUC remained stable at 0.788 (95%CI: 0.779–0.797).
conclusionFemale sex, advancing age, diabetes mellitus, prior fracture history, BMI, serum uric acid, serum calcium and vitamin D are independent determinants of OP in older adults.The nomogram built on these factors offers satisfactory screening accuracy and may assist clinicians in identifying individuals at an elevated risk for osteoporosis to guide personalized preventive strategies.
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