Abstract
The microcirculation plays an important role in bone health. Here, we examine whether albuminuria, a marker of renal microvascular disease, is associated with the risk of hip fracture in older adults (age, 78 years). We find a small independent association in women but not in men. Introduction: The microvascular circulation plays an important role in bone physiology. Two studies of middle-aged adults have found that albuminuria (>30 mg albumin/g creatinine), a disorder of the renal microvasculature, is associated with fracture risk. Here, we examine whether albuminuria is related to hip fracture risk and reduced hip bone mineral density (BMD) in older adults with a mean age of 78 years. Methods: From the Cardiovascular Health Study (41 % male), 3,110 adults with albuminuria testing were followed up for incident hip fracture for up to 9.5 years. BMD was performed in a subset of 1,208 participants. Results: There were 313 hip fractures during follow-up (7.7 % of men; 11.7 % of women). The incidence rate for men, with and without albuminuria, was 1.43 and 0.93/100 person-years of follow-up (p = 0.02); for women, 1.84 and 1.33 (p = 0.04). After adjustment for osteoporosis-related factors, frailty and falling, a doubling of albuminuria was significantly associated with hip fracture risk in women (hazard ratio, 1.12, 95 % CI, 1.001-1.25), but not in men. In the subcohort with BMD measurement, increased urine albumin levels were significantly associated with decreased total hip BMD in men (-0.009 g calcium/cm2 (-0.017, -0.001); p = 0.04), but not in women. Conclusions: In older women, albuminuria is associated with a small, but statistically significant, increased risk of hip fracture independent of other explanatory factors. No such risk appears to be present in men, although their total hip BMD is lower in association with albuminuria.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2993-3000 |
| Number of pages | 8 |
| Journal | Osteoporosis International |
| Volume | 24 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 2013 |
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Keywords
- Albuminuria
- BMD
- DEXA
- Elderly
- Hip fracture
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
Cite this
Albuminuria is associated with hip fracture risk in older adults : The cardiovascular health study. / Barzilay, J. I.; Bůžková, P.; Chen, Z.; De Boer, I. H.; Carbone, L.; Rassouli, N. N.; Fink, H. A.; Robbins, John A.
In: Osteoporosis International, Vol. 24, No. 12, 12.2013, p. 2993-3000.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Albuminuria is associated with hip fracture risk in older adults
T2 - The cardiovascular health study
AU - Barzilay, J. I.
AU - Bůžková, P.
AU - Chen, Z.
AU - De Boer, I. H.
AU - Carbone, L.
AU - Rassouli, N. N.
AU - Fink, H. A.
AU - Robbins, John A
PY - 2013/12
Y1 - 2013/12
N2 - The microcirculation plays an important role in bone health. Here, we examine whether albuminuria, a marker of renal microvascular disease, is associated with the risk of hip fracture in older adults (age, 78 years). We find a small independent association in women but not in men. Introduction: The microvascular circulation plays an important role in bone physiology. Two studies of middle-aged adults have found that albuminuria (>30 mg albumin/g creatinine), a disorder of the renal microvasculature, is associated with fracture risk. Here, we examine whether albuminuria is related to hip fracture risk and reduced hip bone mineral density (BMD) in older adults with a mean age of 78 years. Methods: From the Cardiovascular Health Study (41 % male), 3,110 adults with albuminuria testing were followed up for incident hip fracture for up to 9.5 years. BMD was performed in a subset of 1,208 participants. Results: There were 313 hip fractures during follow-up (7.7 % of men; 11.7 % of women). The incidence rate for men, with and without albuminuria, was 1.43 and 0.93/100 person-years of follow-up (p = 0.02); for women, 1.84 and 1.33 (p = 0.04). After adjustment for osteoporosis-related factors, frailty and falling, a doubling of albuminuria was significantly associated with hip fracture risk in women (hazard ratio, 1.12, 95 % CI, 1.001-1.25), but not in men. In the subcohort with BMD measurement, increased urine albumin levels were significantly associated with decreased total hip BMD in men (-0.009 g calcium/cm2 (-0.017, -0.001); p = 0.04), but not in women. Conclusions: In older women, albuminuria is associated with a small, but statistically significant, increased risk of hip fracture independent of other explanatory factors. No such risk appears to be present in men, although their total hip BMD is lower in association with albuminuria.
AB - The microcirculation plays an important role in bone health. Here, we examine whether albuminuria, a marker of renal microvascular disease, is associated with the risk of hip fracture in older adults (age, 78 years). We find a small independent association in women but not in men. Introduction: The microvascular circulation plays an important role in bone physiology. Two studies of middle-aged adults have found that albuminuria (>30 mg albumin/g creatinine), a disorder of the renal microvasculature, is associated with fracture risk. Here, we examine whether albuminuria is related to hip fracture risk and reduced hip bone mineral density (BMD) in older adults with a mean age of 78 years. Methods: From the Cardiovascular Health Study (41 % male), 3,110 adults with albuminuria testing were followed up for incident hip fracture for up to 9.5 years. BMD was performed in a subset of 1,208 participants. Results: There were 313 hip fractures during follow-up (7.7 % of men; 11.7 % of women). The incidence rate for men, with and without albuminuria, was 1.43 and 0.93/100 person-years of follow-up (p = 0.02); for women, 1.84 and 1.33 (p = 0.04). After adjustment for osteoporosis-related factors, frailty and falling, a doubling of albuminuria was significantly associated with hip fracture risk in women (hazard ratio, 1.12, 95 % CI, 1.001-1.25), but not in men. In the subcohort with BMD measurement, increased urine albumin levels were significantly associated with decreased total hip BMD in men (-0.009 g calcium/cm2 (-0.017, -0.001); p = 0.04), but not in women. Conclusions: In older women, albuminuria is associated with a small, but statistically significant, increased risk of hip fracture independent of other explanatory factors. No such risk appears to be present in men, although their total hip BMD is lower in association with albuminuria.
KW - Albuminuria
KW - BMD
KW - DEXA
KW - Elderly
KW - Hip fracture
UR - http://www.scopus.com/inward/record.url?scp=84890426471&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84890426471&partnerID=8YFLogxK
U2 - 10.1007/s00198-013-2389-3
DO - 10.1007/s00198-013-2389-3
M3 - Article
C2 - 23702700
AN - SCOPUS:84890426471
VL - 24
SP - 2993
EP - 3000
JO - Osteoporosis International
JF - Osteoporosis International
SN - 0937-941X
IS - 12
ER -