Studies on the association between urinary albumin to creatinine ratio (ACR) and bone mineral density (BMD) are still controversial.
This study investigated the association between ACR and BMD in the general US population.
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.
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)).
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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The datasets used and analysed during the current study are available from the corresponding author on reasonable request.
Urinary albumin to creatinine ratio
Bone mineral density
Body mass index
Centers for Disease Control and Prevention
Chronic kidney disease
Dual-energy X-ray absorptiometry
General linear model
National Center for Health Statistics
National Health and Nutrition Examination Survey
Statistical package for the social sciences
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The authors are grateful to the NHANES participants, staff and investigators.
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.
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All participants provided written consent to participate in the NHANES surveys and data collection.
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Consent for publication obtained from participants.
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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
- Bone mineral density
- Urine albumin to creatinine ratio