ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Bone Research
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1574059
Albumin: A mediator of the association between serum calcium and triglyceride-glucose index among Chinese individuals with osteoporotic fractures
Provisionally accepted
- 1Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, China
- 2Kunshan Biomedical Big Data Innovation Application Laboratory, Suzhou, China
- 3Department of Orthopedics, The First People’s Hospital of Kunshan, Gusu School, Nanjing Medical University, Suzhou, China
- 4Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- 5Kunshan municipal Health and Family Planning Information Center, Suzhou, China
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Background: Osteoporotic fractures (OPFs) are a major global health concern, affecting nearly 200 million individuals worldwide. Notably, patients with type 2 diabetes mellitus (T2DM) face a heightened fracture risk, even when bone mineral density (BMD) is normal or elevated. This study investigated the associations between serum calcium (Ca), triglyceride-glucose (TyG) index, albumin, and their interactions in Chinese patients with OPFs.Methods: This cross-sectional study included 1,541 participants who were 50 years of age or older, recruited from the Affiliated Kunshan Hospital of Jiangsu University between January 2017 and August 2023. The primary independent and dependent variables were serum Ca and the TyG index, respectively.Albumin served as the mediating factor in this analysis. The relationship between serum Ca or albumin and the TyG index was investigated using multivariable logistic regression analyses. A mediation analysis was conducted to ascertain whether albumin mediated the relationship between serum Ca and the TyG index.The study revealed a positive correlation between serum Ca and TyG index, with each unit increase in serum Ca associated with a 0.903 increase in TyG index. Albumin partially mediated this relationship, accounting for approximately 21.74% of the effect of serum Ca on TyG index. The models demonstrated a consistent association across various adjustments for confounding variables.Conclusions: Findings suggest a mediation link between serum Ca and albumin and the risk of TyG index. The significance of albumin as a mediator deserves recognition and consideration.
Keywords: Osteoporotic Fractures, Serum Ca, TyG index, albumin, Mediator
Received: 10 Feb 2025; Accepted: 20 Aug 2025.
Copyright: © 2025 Liang, Xu, Cao, Wei, Lin, Jin, Li and Lu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ke Lu, Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, China
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