title: Renal function and bone mineral density in community-dwelling elderly Japanese men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Study.
abstract: End-stage renal failure deteriorates bone mass and increases fracture risk. However, there are conflicting reports in the literature regarding the effects of mild to moderate renal dysfunction on bone mineral density (BMD). We investigated the association between renal function and BMD at the spine and hip and bone metabolism markers in community-dwelling elderly Japanese men. From 2174 male volunteers aged ≥65 years, we examined 1477 men after excluding those with diseases or medications known to affect bone metabolism. Renal function was assessed by serum cystatin C and estimated glomerular filtration rate (eGFR) calculated using the Modification of Diet in Renal Disease Study equation. Bone metabolism was evaluated using levels of serum amino-terminal propeptide of type I procollagen (PINP) and tartrate-resistant acid phosphatase isoenzyme 5b (TRACP-5b), which represent bone metabolic status independent of renal function. eGFR was inversely associated with BMD after adjusting for potential confounders (P < 0.01). Cystatin C showed a weaker but significant association with BMD. eGFR was modestly positively associated with PINP levels (P = 0.04), although cystatin C concentrations were neither associated with PINP nor TRACP-5b levels. Since BMD integrates bone metabolism from the past to present, inverse associations between renal function and BMD may be attributed to past factors, such as obesity. Our findings suggest that low renal function does not affect bone metabolism in a population of community-dwelling elderly Japanese men. Longitudinal studies will be necessary to clarify whether low renal function affects bone loss.
authors.affiliation: Department of Public Health, Kinki University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka 589-8511, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fujita
authors.forename: Masayuki
authors.initials: M
authors.lastname: Iki
authors.forename: Junko
authors.initials: J
authors.lastname: Tamaki
authors.forename: Katsuyasu
authors.initials: K
authors.lastname: Kouda
authors.forename: Akiko
authors.initials: A
authors.lastname: Yura
authors.forename: Eiko
authors.initials: E
authors.lastname: Kadowaki
authors.forename: Yuho
authors.initials: Y
authors.lastname: Sato
authors.forename: Jong-Seong
authors.initials: JS
authors.lastname: Moon
authors.forename: Kimiko
authors.initials: K
authors.lastname: Tomioka
authors.forename: Nozomi
authors.initials: N
authors.lastname: Okamoto
authors.forename: Norio
authors.initials: N
authors.lastname: Kurumatani
mesh_terms: D000368:Aged; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology*; D055316:Cystatin C / Q000378:metabolism; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007564:Japan; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D010024:Osteoporosis / Q000097:blood / Q000503:physiopathology*; D012111:Residence Characteristics; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D055316:Cystatin C
keywords: BMD; BMI; Bone density; CTX; CV; Cr; Creatinine; Cystatin C; DXA; FORMEN; Fujiwara-kyo Osteoporosis Risk in Men; Hcy; MDRD; METs; Men; Modification of Diet in Renal Disease; P1NP; Q; Renal insufficiency; SD; SE; TRACP-5b; amino-terminal propeptide of type I procollagen; body mass index; bone mineral density; coefficient of variation; creatinine; cross-linked carboxy-terminal telopeptide of type I collagen; dual X-ray absorptiometry; eCCr; eGFR; estimated creatinine clearance; estimated glomerular filtration rate; high sensitivity C-reactive protein; homocysteine; hs-CRP; iOC; iPTH; intact osteocalcin; intact parathyroid hormone; metabolic equivalents; quintile; standard deviation; standard error; tartrate-resistant acid phosphatase isoenzyme 5b