Kidney function predicts the rate of bone loss in older individuals: The Cardiovascular Health Study

Linda F. Fried, Michael G. Shlipak, Catherine Stehman-Breen, Anuja Mittalhenkle, Stephen Seliger, Mark Sarnak, John A Robbins, David Siscovick, Tamara B. Harris, Anne B. Newman, Jane A. Cauley

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Abstract

Background. Results of cross-sectional analyses of the association of kidney function with bone mineral density (BMD) have been conflicting. We examined the association of cystatin-C, a new marker of kidney function that is unrelated to lean mass, with initial and follow-up BMD, in an ancillary study of the Cardiovascular Health Study, a population-based cohort of individuals ≥65 years old. Methods. Two years after measurement of cystatin-C and other covariates, the first BMD was measured in Pittsburgh, Pennsylvania and Davis, California, by using dual energy x-ray absorptiometry. Follow-up BMD was measured in Pittsburgh 4 years later. Associations of cystatin-C with initial BMD and the change in BMD (%/y) at the hip were examined with linear regression. Analyses were conducted separately for men and women. Results. In 1519 participants who had cystatin-C and initial BMD assessed, 614 had follow-up BMD. The percent annual change in BMD at the total hip by cystatin-C quartiles was -0.24, -0.13, -0.40, and -0.66%/y (first to fourth quartile) in women and -0.02, -0.30, -0.18, and -0.94%/y in men. After adjusting for potential confounders, cystatin-C was marginally associated with initial BMD in men but not women. Cystatin-C was associated with bone loss in men; after adjustment for weight loss, cystatin-C was not associated with bone loss in women. Conclusion. Kidney dysfunction, as assessed by cystatin-C, is associated with a more rapid loss of BMD at the hip, especially in men. Further studies are needed to confirm these findings and to determine whether this loss leads to an elevated risk of fracture.

Original languageEnglish (US)
Pages (from-to)743-748
Number of pages6
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume61
Issue number7
StatePublished - Jul 2006

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Cystatin C
Bone Density
Kidney
Bone and Bones
Health
Hip
Weight Loss
Linear Models
Cross-Sectional Studies
X-Rays

ASJC Scopus subject areas

  • Aging

Cite this

Fried, L. F., Shlipak, M. G., Stehman-Breen, C., Mittalhenkle, A., Seliger, S., Sarnak, M., ... Cauley, J. A. (2006). Kidney function predicts the rate of bone loss in older individuals: The Cardiovascular Health Study. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 61(7), 743-748.

Kidney function predicts the rate of bone loss in older individuals : The Cardiovascular Health Study. / Fried, Linda F.; Shlipak, Michael G.; Stehman-Breen, Catherine; Mittalhenkle, Anuja; Seliger, Stephen; Sarnak, Mark; Robbins, John A; Siscovick, David; Harris, Tamara B.; Newman, Anne B.; Cauley, Jane A.

In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 61, No. 7, 07.2006, p. 743-748.

Research output: Contribution to journalArticle

Fried, LF, Shlipak, MG, Stehman-Breen, C, Mittalhenkle, A, Seliger, S, Sarnak, M, Robbins, JA, Siscovick, D, Harris, TB, Newman, AB & Cauley, JA 2006, 'Kidney function predicts the rate of bone loss in older individuals: The Cardiovascular Health Study', Journals of Gerontology - Series A Biological Sciences and Medical Sciences, vol. 61, no. 7, pp. 743-748.
Fried, Linda F. ; Shlipak, Michael G. ; Stehman-Breen, Catherine ; Mittalhenkle, Anuja ; Seliger, Stephen ; Sarnak, Mark ; Robbins, John A ; Siscovick, David ; Harris, Tamara B. ; Newman, Anne B. ; Cauley, Jane A. / Kidney function predicts the rate of bone loss in older individuals : The Cardiovascular Health Study. In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2006 ; Vol. 61, No. 7. pp. 743-748.
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abstract = "Background. Results of cross-sectional analyses of the association of kidney function with bone mineral density (BMD) have been conflicting. We examined the association of cystatin-C, a new marker of kidney function that is unrelated to lean mass, with initial and follow-up BMD, in an ancillary study of the Cardiovascular Health Study, a population-based cohort of individuals ≥65 years old. Methods. Two years after measurement of cystatin-C and other covariates, the first BMD was measured in Pittsburgh, Pennsylvania and Davis, California, by using dual energy x-ray absorptiometry. Follow-up BMD was measured in Pittsburgh 4 years later. Associations of cystatin-C with initial BMD and the change in BMD ({\%}/y) at the hip were examined with linear regression. Analyses were conducted separately for men and women. Results. In 1519 participants who had cystatin-C and initial BMD assessed, 614 had follow-up BMD. The percent annual change in BMD at the total hip by cystatin-C quartiles was -0.24, -0.13, -0.40, and -0.66{\%}/y (first to fourth quartile) in women and -0.02, -0.30, -0.18, and -0.94{\%}/y in men. After adjusting for potential confounders, cystatin-C was marginally associated with initial BMD in men but not women. Cystatin-C was associated with bone loss in men; after adjustment for weight loss, cystatin-C was not associated with bone loss in women. Conclusion. Kidney dysfunction, as assessed by cystatin-C, is associated with a more rapid loss of BMD at the hip, especially in men. Further studies are needed to confirm these findings and to determine whether this loss leads to an elevated risk of fracture.",
author = "Fried, {Linda F.} and Shlipak, {Michael G.} and Catherine Stehman-Breen and Anuja Mittalhenkle and Stephen Seliger and Mark Sarnak and Robbins, {John A} and David Siscovick and Harris, {Tamara B.} and Newman, {Anne B.} and Cauley, {Jane A.}",
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T1 - Kidney function predicts the rate of bone loss in older individuals

T2 - The Cardiovascular Health Study

AU - Fried, Linda F.

AU - Shlipak, Michael G.

AU - Stehman-Breen, Catherine

AU - Mittalhenkle, Anuja

AU - Seliger, Stephen

AU - Sarnak, Mark

AU - Robbins, John A

AU - Siscovick, David

AU - Harris, Tamara B.

AU - Newman, Anne B.

AU - Cauley, Jane A.

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N2 - Background. Results of cross-sectional analyses of the association of kidney function with bone mineral density (BMD) have been conflicting. We examined the association of cystatin-C, a new marker of kidney function that is unrelated to lean mass, with initial and follow-up BMD, in an ancillary study of the Cardiovascular Health Study, a population-based cohort of individuals ≥65 years old. Methods. Two years after measurement of cystatin-C and other covariates, the first BMD was measured in Pittsburgh, Pennsylvania and Davis, California, by using dual energy x-ray absorptiometry. Follow-up BMD was measured in Pittsburgh 4 years later. Associations of cystatin-C with initial BMD and the change in BMD (%/y) at the hip were examined with linear regression. Analyses were conducted separately for men and women. Results. In 1519 participants who had cystatin-C and initial BMD assessed, 614 had follow-up BMD. The percent annual change in BMD at the total hip by cystatin-C quartiles was -0.24, -0.13, -0.40, and -0.66%/y (first to fourth quartile) in women and -0.02, -0.30, -0.18, and -0.94%/y in men. After adjusting for potential confounders, cystatin-C was marginally associated with initial BMD in men but not women. Cystatin-C was associated with bone loss in men; after adjustment for weight loss, cystatin-C was not associated with bone loss in women. Conclusion. Kidney dysfunction, as assessed by cystatin-C, is associated with a more rapid loss of BMD at the hip, especially in men. Further studies are needed to confirm these findings and to determine whether this loss leads to an elevated risk of fracture.

AB - Background. Results of cross-sectional analyses of the association of kidney function with bone mineral density (BMD) have been conflicting. We examined the association of cystatin-C, a new marker of kidney function that is unrelated to lean mass, with initial and follow-up BMD, in an ancillary study of the Cardiovascular Health Study, a population-based cohort of individuals ≥65 years old. Methods. Two years after measurement of cystatin-C and other covariates, the first BMD was measured in Pittsburgh, Pennsylvania and Davis, California, by using dual energy x-ray absorptiometry. Follow-up BMD was measured in Pittsburgh 4 years later. Associations of cystatin-C with initial BMD and the change in BMD (%/y) at the hip were examined with linear regression. Analyses were conducted separately for men and women. Results. In 1519 participants who had cystatin-C and initial BMD assessed, 614 had follow-up BMD. The percent annual change in BMD at the total hip by cystatin-C quartiles was -0.24, -0.13, -0.40, and -0.66%/y (first to fourth quartile) in women and -0.02, -0.30, -0.18, and -0.94%/y in men. After adjusting for potential confounders, cystatin-C was marginally associated with initial BMD in men but not women. Cystatin-C was associated with bone loss in men; after adjustment for weight loss, cystatin-C was not associated with bone loss in women. Conclusion. Kidney dysfunction, as assessed by cystatin-C, is associated with a more rapid loss of BMD at the hip, especially in men. Further studies are needed to confirm these findings and to determine whether this loss leads to an elevated risk of fracture.

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