Objective To investigate the relationship between a body shape index(ABSI),bone mineral density(BMD),osteopo-rosis,and fracture risk,and to evaluate its potential value as a predictive marker for skeletal health risks in middle-aged and elderly in-dividuals.This study aims to provide scientific evidence for the early screening and intervention of osteoporosis and fracture risks.Meth-ods Using data from the National Health and Nutrition Examination Survey(NHANES)2017-2020,individuals aged ≥50 years were selected as the study population.ABSI was calculated and categorized into quartiles.The relationship between ABSI and fracture risk was analyzed using logistic regression models while adjusting for demographic characteristics,lifestyle factors,and clinical variables.A re-stricted cubic spline(RCS)model was employed to explore the dose-response relationship between ABSI and fracture risk.Subgroup an-alyses were conducted to identify potential effect modifiers.Results BMD decreased,and the risks of osteoporosis and fractures signifi-cantly increased with higher ABSI quartiles(trend P＜0.05).Compared to the lowest ABSI quartile,individuals in the highest quartile had a significantly increased fracture risk(adjusted OR=1.33,95％CI:1.04-1.70).RCS analysis demonstrated a linear positive cor-relation between ABSI and fracture risk(overall P＜0.001),with fracture risk progressively increasing with higher ABSI levels.Sub-group analyses revealed consistent associations across different age groups,sexes,and BMI categories.Conclusion ABSI is independ-ently associated with lower BMD,higher osteoporosis risk,and increased fracture risk.These findings suggest that ABSI is a simple and effective tool for identifying individuals at high skeletal health risk,providing scientific evidence for the early prevention and intervention of osteoporosis and fractures.

Objective To investigate the relationship between a body shape index(ABSI),bone mineral density(BMD),osteopo-rosis,and fracture risk,and to evaluate its potential value as a predictive marker for skeletal health risks in middle-aged and elderly in-dividuals.This study aims to provide scientific evidence for the early screening and intervention of osteoporosis and fracture risks.Meth-ods Using data from the National Health and Nutrition Examination Survey(NHANES)2017-2020,individuals aged ≥50 years were selected as the study population.ABSI was calculated and categorized into quartiles.The relationship between ABSI and fracture risk was analyzed using logistic regression models while adjusting for demographic characteristics,lifestyle factors,and clinical variables.A re-stricted cubic spline(RCS)model was employed to explore the dose-response relationship between ABSI and fracture risk.Subgroup an-alyses were conducted to identify potential effect modifiers.Results BMD decreased,and the risks of osteoporosis and fractures signifi-cantly increased with higher ABSI quartiles(trend P＜0.05).Compared to the lowest ABSI quartile,individuals in the highest quartile had a significantly increased fracture risk(adjusted OR=1.33,95％CI:1.04-1.70).RCS analysis demonstrated a linear positive cor-relation between ABSI and fracture risk(overall P＜0.001),with fracture risk progressively increasing with higher ABSI levels.Sub-group analyses revealed consistent associations across different age groups,sexes,and BMI categories.Conclusion ABSI is independ-ently associated with lower BMD,higher osteoporosis risk,and increased fracture risk.These findings suggest that ABSI is a simple and effective tool for identifying individuals at high skeletal health risk,providing scientific evidence for the early prevention and intervention of osteoporosis and fractures.