Discordance in Bone Mineral Density between the Lumbar Spine and Femoral Neck Is Associated with Renal Dysfunction
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Purpose: Bone mineral density (BMD) determined by dual-energy X-ray absorptiometry is considered a gold standard for diagnosingosteoporosis. Some people show discordance in BMD values measured at the femur and that at the lumbar spine (LS). The aim of the present study was to investigate whether differences in BMD T-scores between the LS and femur neck (FN) are associatedwith renal dysfunction in the general population of Korea. Materials and Methods: We analyzed national data for 17306 adults from the Korean National Health and Nutrition ExaminationSurvey conducted between 2008 and 2011. BMD T-score differences between LS and FN (termed BMD offset) were calculated bysubtracting FN T-scores from LS T-scores. Diminished renal function was defined as estimated glomerular filtration rates (eGFR)less than 60 mL/min/1.73 m2. Results: Among those aged ≥50 years, BMD offset was negatively associated with eGFR levels. Additionally, eGFR levels decreasedlinearly across increasing BMD offset quartiles. Men and women with an offset of >1.5 showed a 4.79-times and 2.51-times higherrisk of renal dysfunction, respectively, compared to individuals with an offset of ≤0, after adjusting for age, body mass index, educationallevel, current smoking, and physical activity. In contrast, there was little evidence of an association between renal dysfunctionand BMD offset in subjects aged <50 years. Conclusion: Discordance between LS and FN BMDs was significantly associated with renal dysfunction in subjects aged ≥50 years. When assessing bone health in older chronic kidney disease patients, physicians should consider the possibility of BMD discordancebetween LS and FN.
Abstract
Purpose: Bone mineral density (BMD) determined by dual-energy X-ray absorptiometry is considered a gold standard for diagnosingosteoporosis. Some people show discordance in BMD values measured at the femur and that at the lumbar spine (LS). The aim of the present study was to investigate whether differences in BMD T-scores between the LS and femur neck (FN) are associatedwith renal dysfunction in the general population of Korea. Materials and Methods: We analyzed national data for 17306 adults from the Korean National Health and Nutrition ExaminationSurvey conducted between 2008 and 2011. BMD T-score differences between LS and FN (termed BMD offset) were calculated bysubtracting FN T-scores from LS T-scores. Diminished renal function was defined as estimated glomerular filtration rates (eGFR)less than 60 mL/min/1.73 m2. Results: Among those aged ≥50 years, BMD offset was negatively associated with eGFR levels. Additionally, eGFR levels decreasedlinearly across increasing BMD offset quartiles. Men and women with an offset of >1.5 showed a 4.79-times and 2.51-times higherrisk of renal dysfunction, respectively, compared to individuals with an offset of ≤0, after adjusting for age, body mass index, educationallevel, current smoking, and physical activity. In contrast, there was little evidence of an association between renal dysfunctionand BMD offset in subjects aged <50 years. Conclusion: Discordance between LS and FN BMDs was significantly associated with renal dysfunction in subjects aged ≥50 years. When assessing bone health in older chronic kidney disease patients, physicians should consider the possibility of BMD discordancebetween LS and FN.
참고문헌 (37)
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