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Association between urine albumin to creatinine ratio and bone mineral density: a cross-sectional study

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Abstract

Background

Studies on the association between urinary albumin to creatinine ratio (ACR) and bone mineral density (BMD) are still controversial.

Aims

This study investigated the association between ACR and BMD in the general US population.

Methods

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 methods. BMDs were measured by dual-energy X-ray absorptiometry (DXA). After adjusting for multiple covariates, we used general linear model (GLM) to compare the mean of BMD between the quartiles of ACR.

Results

The mean age of participants in this study was 54.6 ± 11.3 years; 52.6% of them were female. ACR was negatively associated with BMD at femoral neck, total femur and lumbar spine (all P < 0.05). After adjusting for covariates, higher level of ACR quartile was associated with lower femoral neck BMD (P for trend = 0.032), but with not total femur and lumbar spine BMD (all P for trend > 0.05)).

Conclusion

ACR was negatively associated with femoral neck BMD in the general US population. Future studies are warranted to confirm our results.

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Data availability

The datasets used and analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

ACR:

Urinary albumin to creatinine ratio

BMD:

Bone mineral density

BMI:

Body mass index

CDC:

Centers for Disease Control and Prevention

CKD:

Chronic kidney disease

DXA:

Dual-energy X-ray absorptiometry

GLM:

General linear model

IQR:

Inter-quartile ranges

LSD:

Least-significant difference

NCHS:

National Center for Health Statistics

NHANES:

National Health and Nutrition Examination Survey

SD:

Standard deviation

SPSS:

Statistical package for the social sciences

References

  1. Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17(12):1726–1733. https://doi.org/10.1007/s00198-006-0172-4

    Article  CAS  PubMed  Google Scholar 

  2. National Osteoporosis Foundation (2017) 54 million Americans affected by osteoporosis and low bone mass (2014). https://www.nof.org/news/54-million-americans-affected-by-osteoporosis-and-low-bone-mass

  3. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 (2016). Lancet (London, England) 388(10053):1603–1658. https://doi.org/10.1016/s0140-6736(16)31460-x

  4. Alem AM, Sherrard DJ, Gillen DL et al (2000) Increased risk of hip fracture among patients with end-stage renal disease. Kidney Int 58(1):396–399. https://doi.org/10.1046/j.1523-1755.2000.00178.x

    Article  CAS  PubMed  Google Scholar 

  5. Nickolas TL, Leonard MB, Shane E (2008) Chronic kidney disease and bone fracture: a growing concern. Kidney Int 74(6):721–731. https://doi.org/10.1038/ki.2008.264

    Article  PubMed  PubMed Central  Google Scholar 

  6. National Institute for Health and Care Excellence (NICE) (2015) Chronic kidney disease in adults: assessment and management. https://www.nice.org/uk/guidance/cg182/chapter/1-Recommendations

  7. van der Velde M, Matsushita K, Coresh J et al (2011) Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts. Kidney Int 79(12):1341–1352. https://doi.org/10.1038/ki.2010.536

  8. Prisby RD, Ramsey MW, Behnke BJ et al (2007) Aging reduces skeletal blood flow, endothelium-dependent vasodilation, and NO bioavailability in rats. J Bone Miner Res 22(8):1280–1288. https://doi.org/10.1359/jbmr.070415

    Article  CAS  PubMed  Google Scholar 

  9. Barzilay JI, Buzkova P, Chen Z et al (2013) Albuminuria is associated with hip fracture risk in older adults: the cardiovascular health study. Osteoporos Int 24(12):2993–3000. https://doi.org/10.1007/s00198-013-2389-3

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Lee YY, Kim HB, Lee JW et al (2016) The association between urine albumin to creatinine ratio and osteoporosis in postmenopausal women with type 2 diabetes. J Bone Metabol 23(1):1–7. https://doi.org/10.11005/jbm.2016.23.1.1

    Article  Google Scholar 

  11. Choi SW, Kim HY, Ahn HR et al (2013) Association of bone mineral density with albuminuria and estimated glomerular filtration rate: the Dong-gu study. Kidney Blood Press Res 37(2–3):132–141. https://doi.org/10.1159/000350067

    Article  CAS  PubMed  Google Scholar 

  12. Yu TY, Kim HY, Lee JM et al (2018) Association between bone mineral density and albuminuria: cross-sectional analysis of data from the 2011 Korea National Health and Nutrition Examination Survey V-2. Endocrinol Metabol (Seoul, Korea) 33(2):211–218. https://doi.org/10.3803/EnM.2018.33.2.211

    Article  CAS  Google Scholar 

  13. Zhao X, Zhang XM, Yuan N et al (2019) Associations of bone mineral density and bone metabolism indices with urine albumin to creatinine ratio in Chinese patients with type 2 diabetes. Exp Clin Endocrinol Diabetes 127(1):50–55. https://doi.org/10.1055/a-0762-0341

    Article  CAS  PubMed  Google Scholar 

  14. Centers for Disease Control and Prevention: National Health and Nutrition Examination Survey (NHANES) (2019) Body composition procedures manual. https://www.cdc.gov/ezpwelchjhmiedu/nchs/data/nhanes/data/

  15. Body composition procedures manual (2013). https://www.cdc.gov/nchs/data/nhanes/

  16. Chavers BM, Simonson J, Michael AF (1984) A solid phase fluorescent immunoassay for the measurement of human urinary albumin. Kidney Int 25(3):576–578. https://doi.org/10.1038/ki.1984.57

    Article  CAS  PubMed  Google Scholar 

  17. Creatinine Measurement Module Operating and Service Instructions (1979) Beckman ASTRA. Beckman Instruments Inc, Brea (CA)

    Google Scholar 

  18. Busby DE, Bakris GL (2004) Comparison of commonly used assays for the detection of microalbuminuria. J Clin Hypertens (Greenwich, Conn) 6(11 Suppl 3):8–12. https://doi.org/10.1111/j.1524-6175.2004.04237.x

    Article  CAS  Google Scholar 

  19. Christell H, Gullberg J, Nilsson K et al (2019) Willingness to pay for osteoporosis risk assessment in primary dental care. Health Econ Rev 9(1):14. https://doi.org/10.1186/s13561-019-0232-z

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors are grateful to the NHANES participants, staff and investigators.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China

    Kemal Sherefa Oumer, Yawen Liu, Tesfaye Getachew Charkos & Shuman Yang

Authors
  1. Kemal Sherefa Oumer
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  2. Yawen Liu
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  3. Tesfaye Getachew Charkos
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  4. Shuman Yang
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Contributions

KSO, YL and SY contributed to the study conception and design. KSO collected data and conducted the analysis. The first draft of the manuscript was written by KSO, and all the authors commented on the previous version of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Shuman Yang.

Ethics declarations

Ethics approval

All participants provided written consent to participate in the NHANES surveys, and data collection was approved by the National Center for Health Statistics (NCHS) Research Ethics Review Board.

Consent to participate

All participants provided written consent to participate in the NHANES surveys and data collection.

Consent for publication

Consent for publication obtained from participants.

Conflict of interest

The authors declare that they have no competing interests.

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Oumer, K.S., Liu, Y., Charkos, T.G. et al. Association between urine albumin to creatinine ratio and bone mineral density: a cross-sectional study. Ir J Med Sci 191, 427–432 (2022). https://doi.org/10.1007/s11845-021-02551-0

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  • DOI: https://doi.org/10.1007/s11845-021-02551-0

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