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

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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Fig. 1

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

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Acknowledgements

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

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Affiliations

Authors

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 (2021). https://doi.org/10.1007/s11845-021-02551-0

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Keywords

  • Bone mineral density
  • Osteoporosis
  • Urine albumin to creatinine ratio