Objective To explore the relationship between sputum index ( ABI) and plasma atherogenic index (PAI) and postmenopausal osteoporosis. Methods A total of 402 women with menopause age of more than 5 years who were admitted to our ward and outpatient clinics from February 2015 to December 2017 were enrolled. They were from 45 to 80 years of age. The data of age, duration of menopause, height, weight, lipid profile, ABI, bone mineral density (BMD) value, and history of oral contraceptive use were recorded and compared. The level of significance was accepted as P < 0. 05. Results A total of 96 postmenopausal patients with osteoporosis were included in the study. The mean age was 58. 3±6. 4 years. In the control group,there were 101 postmenopausal women without osteoporosis, with a mean age of 55. 8±4. 7 years. There was no statistically significant difference with respect to triglyceride level. However, in the osteoporosis group, the levels of total cholesterol, low-density lipoprotein (LDL) , PAI, and ABI were lower, but the level of high-density lipoprotein (HDL) was higher than those in control group (P<0. 05, respectively). At the same time, we found that serum HDL, LDL, total cholesterol, PAI, and ABI levels were correlated with BMD of the femur and lumbar spine. Conclusion High level of HDL, and low levels of LDL, total cholesterol, ABI, and PAI are risk factors of BMD. [ABSTRACT FROM AUTHOR]