Albuminuria is associated with hip fracture risk in older adults

The cardiovascular health study

J. I. Barzilay, P. Bůžková, Z. Chen, I. H. De Boer, Laura D Carbone, N. N. Rassouli, H. A. Fink, J. A. Robbins

Research output: Contribution to journalArticle

10 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)2993-3000
Number of pages8
JournalOsteoporosis International
Volume24
Issue number12
DOIs
StatePublished - Dec 1 2013
Externally publishedYes

Fingerprint

Albuminuria
Hip Fractures
Bone Density
Health
Pelvic Bones
Albumins
Accidental Falls
Kidney
Bone and Bones
Microcirculation
Microvessels
Osteoporosis
Creatinine
Urine
Calcium
Incidence

Keywords

  • Albuminuria
  • BMD
  • DEXA
  • Elderly
  • Hip fracture

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Barzilay, J. I., Bůžková, P., Chen, Z., De Boer, I. H., Carbone, L. D., Rassouli, N. N., ... Robbins, J. A. (2013). Albuminuria is associated with hip fracture risk in older adults: The cardiovascular health study. Osteoporosis International, 24(12), 2993-3000. https://doi.org/10.1007/s00198-013-2389-3

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, Laura D; Rassouli, N. N.; Fink, H. A.; Robbins, J. A.

In: Osteoporosis International, Vol. 24, No. 12, 01.12.2013, p. 2993-3000.

Research output: Contribution to journalArticle

Barzilay, JI, Bůžková, P, Chen, Z, De Boer, IH, Carbone, LD, Rassouli, NN, Fink, HA & Robbins, JA 2013, 'Albuminuria is associated with hip fracture risk in older adults: The cardiovascular health study', Osteoporosis International, vol. 24, no. 12, pp. 2993-3000. https://doi.org/10.1007/s00198-013-2389-3
Barzilay, J. I. ; Bůžková, P. ; Chen, Z. ; De Boer, I. H. ; Carbone, Laura D ; Rassouli, N. N. ; Fink, H. A. ; Robbins, J. A. / Albuminuria is associated with hip fracture risk in older adults : The cardiovascular health study. In: Osteoporosis International. 2013 ; Vol. 24, No. 12. pp. 2993-3000.
@article{198abc78e46d4075975e81d697bb448d,
title = "Albuminuria is associated with hip fracture risk in older adults: The cardiovascular health study",
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.",
keywords = "Albuminuria, BMD, DEXA, Elderly, Hip fracture",
author = "Barzilay, {J. I.} and P. Bůžkov{\'a} and Z. Chen and {De Boer}, {I. H.} and Carbone, {Laura D} and Rassouli, {N. N.} and Fink, {H. A.} and Robbins, {J. A.}",
year = "2013",
month = "12",
day = "1",
doi = "10.1007/s00198-013-2389-3",
language = "English (US)",
volume = "24",
pages = "2993--3000",
journal = "Osteoporosis International",
issn = "0937-941X",
publisher = "Springer London",
number = "12",

}

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, Laura D

AU - Rassouli, N. N.

AU - Fink, H. A.

AU - Robbins, J. A.

PY - 2013/12/1

Y1 - 2013/12/1

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

VL - 24

SP - 2993

EP - 3000

JO - Osteoporosis International

JF - Osteoporosis International

SN - 0937-941X

IS - 12

ER -