# Association between platelet-to-albumin ratio and total spine bone mineral density in older adults with thoracolumbar fragility fractures: a retrospective cross-sectional study

## TL;DR

This study finds that a higher platelet-to-albumin ratio is linked to lower spine bone density in older adults with spinal fractures.

## Contribution

The study introduces the platelet-to-albumin ratio as a potential clinical indicator for spine bone health in thoracolumbar fragility fracture patients.

## Key findings

- High platelet-to-albumin ratio groups showed lower total spine bone mineral density.
- Platelet-to-albumin ratio had a significant negative association with total spine BMD after adjustment.
- The neutrophil-to-albumin ratio lost significance after adjustment.

## Abstract

Global aging elevates the incidence of thoracolumbar fragility fractures (TLFFs), which are linked to osteoporosis. Platelets (PLT) and albumin influence bone health; the platelet-to-albumin ratio (PAR) is applied in multi-disease research, but it has not yet been applied to patients with TLFF. This study thus explores PAR’s association with bone mineral density (BMD).

This retrospective cross-sectional analysis based on a cohort of TLFF patients included 703 elderly TLFF patients from Huizhou First Hospital (2020–2025). BMD was measured, PAR calculated, and grouped; covariates were collected. Subsequently, characterization of the study population, univariate linear regression analyses, and subgroup as well as interaction analyses were carried out.

High-PAR groups had higher PLT, lower albumin, and lower BMD. PAR showed a significant negative association with total spine BMD (TS-BMD) even after adjustment; the initial association of neutrophill-to-albumin ratio (NPAR) became non-significant post-adjustment.

In elderly TLFF patients, PAR is negatively associated with TS-BMD. As an easily measurable index, PAR may act as a clinical tool.