Abstract: Objective To explore the relationship between osteoporosis and biochemical marks of bone metabolism in aged people with high risk of osteoporosis. Methods General information of the aged people older than 65 were collected from the health examinations. Cockcroft formula and OSTA index were used to screen high risk population of osteoporosis combined with slight decrease of endogenous creatinine clearance rate. The left femoral neck bone mineral density was detected by dual-energy X ray absorptiometry (DXA). Meanwhile, blood biochemical indicators, biochemical markers of bone metabolism was detected. Results A total of 236 high risk elderly patients with osteoporosis with the average age of 77.40±5.46 years were detected. Logistic regression analysis showed that OSTA and 25(OH)VitD₃ were negative correlation with osteoporosis (OR=0.08, OR=0.65). The level of PTH was positive correlation with osteoporosis(OR=1.54). Conclusion OSTA index is suitable for screening high risk elderly patients with osteoporosis. 25(OH)VitD₃ insufficiency is highly prevalent in this population. Appropriate supplementary of active Vitamin D and calcium is important to the above crowd to reduce the risk of osteoporosis.