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Studies on the association between urinary albumin to creatinine ratio (ACR) and bone mineral density (BMD) are still controversial. This study investigated the association between ACR and BMD in the general US population. This cross-sectional study identified 2007 individuals aged 40 or above years with complete and valid data on urinary albumin to creatinine ratio (ACR) and femoral neck, total femur and lumbar spine BMD from the National Health and Nutrition Examination Survey 2013-2014. ACR was directly measured with established me