ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1560013
The association between The albumin to globulin ratio and thoracic spine bone mineral density in adolescents: NHANES 2011-2016
Provisionally accepted
- 1Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
- 2Guangfu People's Hospital, Wuzhong District,Suzhou, Wuzhong District,Suzhou, China
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Numerous studies have demonstrated a strong correlation between osteoporosis and nutritional status and inflammation, while albumin and globulin are important references for nutritional status and inflammation, respectively. The albumin to globulin ratio (AGR), which combines the levels of albumin(ALB) and globulin(GLB), is a new comprehensive index that offers a more precise reflection of the inflammatory state of the body and its nutritional status. However, the connection between AGR and thoracic spine bone mineral density (BMD) remains poorly understood. The purpose of this research was to examine the link between the AGR and thoracic spine BMD in adolescents.This study used the most recent data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016, and used weighted multivariate linear regression modelling to examine the correlation between AGR and thoracic spine BMD in adolescents. Threshold effects and nonlinear relationships were assessed using a smoothed curve-fitting algorithm alongside threshold effects analysis. Furthermore, subgroup analyses and interaction tests were performed.The study comprised a total of 3,000 participants who were all aged 20 years or younger. Based on weighted multivariate linear regression analysis, in the fully adjusted model, a significantly higher thoracic spine BMD was found in the highest AGR quartile compared to the lowest AGR quartile (P < 0.05). After adjusting for variables, subgroup analyses showed no significant interaction effects.The study of threshold effects and the fitting of smooth curves identified a specific threshold effect for AGR and thoracic BMD with an inflection point of 1.237, after which AGR was significantly positively correlated with thoracic spine BMD.The study identified a notable positive correlation between AGR and adolescent thoracic spine BMD. This finding indicates a potential correlation between higher AGR and higher thoracic spine BMD, which may be indicative of a reduced risk of developing Osteoporosis (OP). This emphasizes the importance of considering nutritional and inflammatory status in the prevention of OP, thereby validating the utilisation of AGR as a pivotal marker for the development of early intervention methodologies. Keywords albumin to globulin ratio (AGR), bone mineral density (BMD), osteoporosis, NHANES, adolescent
Keywords: albumin to globulin ratio (AGR), Bone Mineral Density (BMD), Osteoporosis, NHANES, Adolescent
Received: 13 Jan 2025; Accepted: 20 May 2025.
Copyright: © 2025 Yan, Liu, Dai, Li, Zhang and Li. 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:
peng Zhang, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
liuyan Li, Guangfu People's Hospital, Wuzhong District,Suzhou, Wuzhong District,Suzhou, China
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