Objective To analyze the correlation between bone mineral density(BMD)and muscle mass and physical function level in middle-aged and elderly women,and to provide certain reference for the prevention and treatment of osteosarcopenia.Methods The clinical data of 111 female patients aged ≥45 years old who received the Affiliated Hospital of Nanjing University of Chinese Medicine from October 2021 to June 2023 were selected.Dual-energy X-ray absorptiometry(DXA)was used to detect the BMD of lumbar and appendicular muscle mass(ASM),appendicular skeletal muscle mass index(ASMI)was calculated as the index of muscle mass.The physical function level was measured by the timed up and go test(TUG).The groups were grouped according to age and BMD,and the differences in age,body mass index(BMI),ASMI,TUG and BMD among all groups were compared.The detection rate of low muscle mass in BMD groups was also compared.Pearson method was used to analyze the correlation between each index and BMD.Results BMD decreased with increasing age(P＜0.001),and the TUG increased with increasing age(P＜0.001).ASMI showed that 45-55 years old group was higher than over 66 years old group,and the difference was statistically significant(P＜0.05).There were no signifi-cant differences in BMI and ASMI among the different age groups(P＞0.05).The age and TUG of BMD groups increased with the de-crease of BMD,and the differences were statistically significant(P＜0.001),while ASMI(P＜0.001)decreased with the decrease of BMD.The BMI of normal bone mass group was higher than that of osteoporosis group,and the difference was statistically significant(P＜0.05).There was no significant difference in BMI among the different BMD groups(P＞0.05).Among the 111 patients,49.6％had osteoporosis,and 72.1％had low muscle mass.The detection rates of low muscle mass in different BMD groups were 85.5％,64.3％and 53.6％,respectively,and the difference was statistically significant(P＜0.05).BMD was negatively correlated with age(r=-0.328,P=0.002),TUG(r=-0.262,P=0.017),and positively correlated with BMI(r=0.224,P=0.042),ASMI(r=0.291,P=0.008).Conclusion Muscle mass and physical functional level are important factors affecting BMD in middle-aged and elderly women.Early intervention of muscle mass and improvement of physical functional level can delay bone loss and improve bone me-tabolism in middle-aged and elderly women.