Association Between Liver Fibrosis (FIB-4) Index and Vertebral Fracture in Middle-aged and Older Adults in the United States: A Cross-Sectional Study of NHANES 2013-2014

Objective This study was to examine the association between FIB-4(fibrosis index based on four factors) and the occurrence of vertebral fractures in Middle-aged and Older Americans. Methods Patients ⩾45years of age from the 2013–2014 NHANES database were selected for this study. Restricted cubic spline models and weighted logistic regression models were used to assess the association between FIB-4 and the occurrence of vertebral fractures in Middle-aged and Older Americans. The predictive value of the FIB-4 on the occurrence of vertebral fractures was assessed using receiver operating characteristic curves (ROC). To examine the robustness of the main findings, a sensitivity analysis was conducted. Results A total of 2188 patients were included in the analysis, of whole 147 suffered vertebral fractures. Fully adjusted logistic regression showed a significant linear relationship between FIB-4 and the occurrence of vertebral fracture in Middle-aged and Older Americans (P < 0.05),with a linear relationship observed between the FIB-4 index and the risk of vertebral fractures. Additionally, the FIB-4 index demonstrated good predictive performance for the incidence of vertebral fractures. Conclusions This study found that the FIB-4 index, as a novel and non-invasive liver fibrosis biomarker, can predict the risk of vertebral fractures in middle-aged and older Americans, which has clinical significance for the prevention and management of vertebral fractures in middle-aged and older Americans.