Mini abstract <p>Low-sodium salt has a protective effect on BMD and also reduces the risk of osteopenia due to elevated blood glucose. This provides a direct and effective way to improve bone health in patients with hyperglycemia.</p> Objective <p>There is no consensus on the relationship between salt type and bone mineral density (BMD). This study examined the factors affecting osteoporosis and the relationship between low-sodium salt consumption with osteoporosis based on the Substitute Salt and Stroke Study (SSaSS).</p> Methods <p>This study was a cross-sectional study and compares the prevalence and characteristics of osteoporosis and osteopenia. Multiple linear regression and restricted spline models were used to analyze the factors affecting BMD and its dose–response relationship with osteoporosis and to compare the effects of different salts.</p> Results <p>The rates of osteoporosis and osteopenia were lower in those consuming low-sodium salt (31.11% and 38.52%) than in those consuming normal salt (38.65% and 41.10%). BMD was higher in the population consuming low-sodium salt than in that using normal salt (= 0.64, 95%CI: 0.25, 0.97). Age, gender, and blood glucose level interacted with low-sodium salt and together affected BMD. Analysis of the dose–response relationship revealed a positive linear association between elevated blood glucose and the risk of osteopenia (<i>P</i> for overall &lt; 0.05, <i>P</i> for nonlinear = 0.77), but intake of low-sodium salt significantly reduced this risk. The risk of OP increased with age (<i>P</i> for overall &lt; 0.05, <i>P</i> for nonlinear = 0.72); low-sodium salt intake reduced this risk, with the effect being more pronounced among individuals &lt; 70&#xa0;years old.</p> Conclusion <p>Low-sodium salt has a positive effect on maintaining BMD. Elevated blood glucose and age &lt; 70&#xa0;years increase the risk of osteoporosis, but use of low-sodium salt mitigates this risk.</p>