Objective To explore the relationships between bone mineral density, osteoporosis and serum lipid profiles, blood cell count ratio in patients with spine degeneration diseases indicating for surgery. Methods One hundred and eleven patients with spine degeneration diseases indicating for surgery who met the inclusion criteria were recruited. Lumbar BMD was measured using quantitative computed tomography (QCT) before the surgery. Total cholesterol, triglyceride, high-density lipoprotein cholesterol? and low-density lipoprotein cholesterol in serum were measured simultaneously. The platelet, neutrophil, lymphocyte, and monocyte in whole blood were counted to calculate platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, and monocyte,lymphocyte ratio. Spearman rank correlation was used to analyze the correlation between each index and BMD. Multiple linear regression was used to analyze the influence factors of BMD. Binary logistic regression was used to explore factors associated with osteoporosis. Results The average age of 111 patients was 63.00±7.00 years. The incidence of osteoporosis was 41.0%. BMD was negatively correlated with age (rs = - 0.427, P< 0.001), TC ( rs = - 0.196, P = 0.040), and HDL-C ( rs = - 0.280, P = 0.003). The associations between age (ß= -0.010? P<0.001), HDL-C (ß= -0.088, P= 0.034) and lgBMD were statistically significant. Age and HDL-C were higher in osteoporosis group than in non-osteoporosis group, and the difference was statistically significant ( t = -4.326, P< 0.001, U= 1816.500, P = 0.031). However, only the association between age ( ß = 0.164, P < 0.001) and osteoporosis was statistically significant. Conclusion Patients with spine degeneration diseases indicating for surgery have a higher incidence of osteoporosis. Age and HDL-C are the significant independent predictors of BMD of the lumbar spine, but only age is associated with osteoporosis. [ABSTRACT FROM AUTHOR]