Model performance was assessed by discrimination (AUROC), calibration (calibration curve and Hosmer-Lemeshow test), decision curve analysis (DCA), and risk stratification.<h4>Results</h4>Female sex, higher health assessment questionnaire-disability index (HAQ-DI), elevated alkaline phosphatase (ALP), increased ApoA1/ApoB ratio, higher free fatty acids (FFA), and lower body mass index (BMI) were independent predictors of osteoporosis and were included in the nomogram. Here, APOA1 is linked to osteoporosis.