| Objective Osteoporosis (OP) is a significant health and economic burden as a growing health problem worldwide. This study aims to explore the potential diagnostic value of uric acid/high-density lipoprotein cholesterol ratio (UHR) in OP in middle-aged and elderly people without diabetes. Methods The clinical data of 300 non-diabetic middle-aged and elderly subjects (159 in the osteoporosis group and 141 in the normal bone group) were retrospectively analyzed, and the correlation between UHR and OP in this population was analyzed using SPSS 27.0. Results There were significant differences between the osteoporosis group and the normal bone mineral density group in terms of age, Hb, HbA1c, UA, TG and HDL-C. Novel indicators such as TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and UA/HDL-C were calculated and analyzed, showing that there were differences between the two groups. A binary logistic regression model was developed by combining the variables of age, gender, hemoglobin, HbA1c and lipid ratio. The model showed that age was an independent risk factor for bone abnormalities and UHR was an independent protective factor. the AUC values of UHR, age and the combination of the two were 0.642, 0.724 and 0.762, respectively, which showed a good predictive value. Correlation analysis confirmed that UHR was positively correlated with bone mineral density in the lumbar spine and hip, and inversely correlated with various femoral stress ratios (femoral neck, intertrochanteric, and femoral stem stress ratios), with statistically significant differences (P<0.05). Conclusion For non-diabetic middle-aged and elderly population over 50 years of age, UHR is a protective factor against bone abnormalities, which is expected to assist in the early diagnosis and management of osteoporosis in the clinical setting. This study was limited to a specific population and did not involve other age groups or diabetic patients, and the sample group could be further expanded in the future and the application and mechanism of UHR in a wider population could be verified. |