Serum albumin and the prognostic nutritional index independently predict fracture risk in elderly women
Authors' conclusion
In conclusion, serum albumin and PNI independently predicted fracture risk in elderly women; however, the underlying mechanisms remain to be elucidated.
Study context
- Population
- Community-dwelling Swedish women aged 75–80 years
- Participants
- 2,966 women
- Exposure
- Lower vs higher serum albumin and Prognostic Nutritional Index (PNI)
- Outcome
- Fracture risk per 1 SD decrease in albumin and PNI
- Follow-up
- Median 8.0 years
Methodological detailscommunity-dwelling, Cox proportional hazards and competing risk analyses
- Community-dwelling
- Cox proportional hazards and competing risk analyses
Main finding
As reported in the abstract
median follow-up 8.0 years
Major osteoporotic fractures (MOF), albumin: HR per 1 SD decrease
1.13
95% CI 1.06–1.22p<0.01
MOF, PNI: HR per 1 SD decrease
1.18
1.05–1.31p<0.01
Any fracture, albumin: HR
1.12
1.05–1.19p<0.01
Any fracture, PNI: HR
1.17
1.07–1.29p<0.01
Observational data: associations, not effects.
Further findings
Physical function, injurious falls and mortality
- Injurious falls
- 499
- Deaths
- 551
- Albumin, and to a lesser extent PNI, consistently associated with better physical function and lower risk of injurious falls and mortality
Bone density and microarchitecture · baseline
- No significant associations between albumin or PNI and DXA-derived bone mineral density (BMD); only limited and inconsistent associations with high-resolution peripheral quantitative computed tomography (HR-pQCT) parameters
Original publication
Serum albumin and the prognostic nutritional index independently predict fracture risk in elderly women. J Bone Miner Res. Published 2 April 2026. doi:10.
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