Association of Bone Mineral Density with Albuminuria and Estimated Glomerular Filtration Rate : The Dong-gu Study

Choi, Seong-Woo; Kim, Hye-Yeon; Ahn, Hye-Ran; Lee, Young‐Hoon; Kweon, Sun-Seog; Choi, Jin‐Su; Rhee, Jung-Ae; Nam, Hae-Sung; Jeong, Seul-Ki; Park, Kyeong-Soo; Ryu, So Yeon; Song, Ho Jun; Shin, Min Ho

doi:10.1159/000350067

Cited by 16 publications

(15 citation statements)

References 44 publications

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“…In trying to elucidate the implications of kidney function on BMD in elderly women, we began by performing a non-systematic literature search. Although lack of longitudinal studies and differences in study populations make comparison of results difficult, this search indicated an association between kidney function and BMD [ 17 – 21 , 23 , 28 , 30 ], though whether mediated through differences in sex, age and weight is unclear [ 18 , 19 ]. The homogeneity of the OPRA cohort, followed for 10 years, allowed us to address this gap in knowledge and make reliable conclusions about the association between kidney function and BMD in this elderly age group.…”

Section: Discussionmentioning

confidence: 99%

Reduced kidney function is associated with BMD, bone loss and markers of mineral homeostasis in older women: a 10-year longitudinal study

et al. 2017

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SummaryKidney function decreases with age; however, the long-term influence on bone density (BMD) in older women already at risk of osteoporosis is unknown. We followed kidney function and bone loss for 10 years. Declining kidney function was adversely associated with bone loss and mineral homeostasis in old women, though it attenuated with advanced aging.IntroductionExisting studies do not fully address the relationship between kidney function and bone metabolism with advanced aging in Caucasian women. This study describes the association between kidney function, BMD, bone loss and bone metabolism in older women and provides a review of the available literature for context.MethodsWe studied participants from the OPRA cohort with follow-up after 5 and 10 years. Using plasma cystatin C (cysC), estimated glomerular function rate (eGFR) was evaluated at age 75 (n = 981), 80 (n = 685) and 85 (n = 365). Women were stratified into “normal” function (CKD stages 1–2), “intermediate” (stage 3a) and “poor” (stages 3b–5), and outcome measures—BMD, bone loss and markers of mineral homeostasis—were compared.ResultsFemoral neck (FN) BMD positively associated with kidney function at 75 years old ( = 0.001, p = 0.028) and 80 years old ( = 0.001, p = 0.001), although with small effect size. Prevalence of osteoporosis (FN T-score ≤ − 2.5) did not differ with kidney function. Measured at age 75, women with poor kidney function had higher annual percentage bone loss over 5 years compared to those with normal function (2.3%, 95% CI 1.8–2.8 versus 1.3%, 95% CI 1.1–1.5, p = 0.007), although not when measured from age 80 or 85. Additionally, markers of mineral homeostasis (PTH, phosphate, vitamin D, calcium), CRP and osteocalcin differed by kidney function.ConclusionsIn old women, kidney function is associated with BMD, bone loss and altered mineral homeostasis; probably, a relationship attenuated in the very elderly.Electronic supplementary materialThe online version of this article (10.1007/s00198-017-4221-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Reduced kidney function is associated with BMD, bone loss and markers of mineral homeostasis in older women: a 10-year longitudinal study

et al. 2017

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“…In addition, many previous laboratory studies have suggested that angiogenesis promoted osteogenesis. 2,3 Choi et al 4 reported that the urine albumin-creatinine ratio (ACR) was negatively correlated with bone mineral density (BMD) at the lumbar spine and femoral neck in females. Another survey 5 with follow-up lasing 8.4 years from Norway demonstrated that ACR was associated with non-vertebral fractures in females without diabetes.…”

Section: Introductionmentioning

confidence: 99%

Microangiopathy is associated with bone loss in female type 2 diabetes mellitus patients

Zhong

Zhang

et al. 2018

Diabetes and Vascular Disease Research

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Objective: Type 2 diabetes mellitus complicated with microvascular diseases can be used as a model to study the relationship between bone health and the microvascular situation. Methods: A total of 2,170 patients with type 2 diabetes mellitus (1,188 postmenopausal females and 982 males aged ⩾50 years) were included in our cross-sectional study. These patients were grouped according to 24-hour urine protein level: Group I (<30 mg), Group II (30-299 mg) and Group III (≥300 mg). Bone mineral density of the lumbar spine, hip and femoral neck was evaluated by dual-energy X-ray absorptiometry. Fundus oculi photography for diabetic retinopathy and 24-h urine protein for diabetic nephropathy were used as markers of microangiopathy in type 2 diabetes mellitus. Characteristics of the patients and bone mineral density were compared. Multivariate analysis was used to study the association between bone mineral density and microangiopathy. Statistical analysis was performed using SPSS 20.0. p < 0.05 was considered statistically significant. Results: Group III had the lowest bone mineral density level in both genders. Multivariate analysis revealed that microangiopathy was negatively correlated with bone mineral density in females (lumbar: r = -0.522, p < 0.001; hip: r = -0.301, p = 0.010; femoral neck: r = -0.314, p = 0.009), but not in males, after adjustment for age, body mass index, hypertension, hyperlipidemia, diabetic status, hepatic function, kidney function, sex hormones and 25(OH) vitamin D. Conclusion:These results demonstrate an independent negative correlation between microangiopathy and bone mineral density in postmenopausal female type 2 diabetes mellitus patients.

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“…A few large cross‐sectional studies have reported that increased urine albumin is associated with lower BMD, but prospective analyses appear inconclusive and limited to small studies in narrow populations . Prospective studies have reported a positive association between urine albumin and risk of nonvertebral fractures, with some, but not all, reporting that the increased risk was present only in women and not men.…”

Section: Introductionmentioning

confidence: 99%

Association of Increased Urinary Albumin With Risk of Incident Clinical Fracture and Rate of Hip Bone Loss: the Osteoporotic Fractures in Men Study

Fink

Langsetmo

et al. 2016

Journal of Bone and Mineral Research

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Prior studies suggest that increased urine albumin is associated with a heightened fracture risk in women, but results in men are unclear. We used data from MrOS, a prospective cohort study of community-dwelling men aged ≥65 years, to evaluate the association of increased urine albumin with subsequent fractures and annualized rate of hip bone loss. We calculated albumin/creatinine ratio (ACR) from urine collected at the 2003-05 visit. Subsequent clinical fractures were ascertained from triannual questionnaires and centrally adjudicated by review of radiographic reports. Total hip BMD was measured by DXA at the 2003-05 visit and again an average of 3.5 years later. We estimated risk of incident clinical fracture using Cox proportional hazards models, and annualized BMD change using ANCOVA. Of 2982 men with calculable ACR, 9.4% had ACR ≥30 mg/g (albuminuria) and 1.0% had ACR ≥300 mg/g (macroalbuminuria). During a mean of 8.7 years of follow-up, 20.0% of men had an incident clinical fracture. In multivariate-adjusted models, neither higher ACR quintile (p for trend 0.75) nor albuminuria (HR vs. no albuminuria, 0.89 [95%CI, 0.65-1.20]) was associated with increased risk of incident clinical fracture. Increased urine albumin had a borderline significant, multivariate-adjusted, positive association with rate of total hip bone loss when modeled in ACR quintiles (p=0.06), but not when modeled as albuminuria versus no albuminuria. Macroalbuminuria was associated with a higher rate of annualized hip bone loss compared to no albuminuria (-1.8% more annualized loss than in men with ACR <30 mg/g; p<0.001), but the limited prevalence of macroalbuminuria precluded reliable estimates of its fracture associations. In these community-dwelling older men, we found no association between urine albumin levels and risk of incident clinical fracture, but found a borderline significant, positive association with rate of hip bone loss.

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Association of Bone Mineral Density with Albuminuria and Estimated Glomerular Filtration Rate : The Dong-gu Study

Cited by 16 publications

References 44 publications

Reduced kidney function is associated with BMD, bone loss and markers of mineral homeostasis in older women: a 10-year longitudinal study

Reduced kidney function is associated with BMD, bone loss and markers of mineral homeostasis in older women: a 10-year longitudinal study

Microangiopathy is associated with bone loss in female type 2 diabetes mellitus patients

Association of Increased Urinary Albumin With Risk of Incident Clinical Fracture and Rate of Hip Bone Loss: the Osteoporotic Fractures in Men Study

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