When aCCI was examined as a continuous variable, the multivariable-adjusted model (BMI, HbA1c, TG, LDL-C, ALB, ALT, eGFR, Ca, smoking, drinking, exercising and FN BMD: model 3) showed that the osteoporosis risk increased by 12.1% (HR 1.121, 95% CI 1.041–1.206, P = 0.002) as aCCI increased by one unit. Here, ALB is linked to osteoporosis.