title: Lower Serum Creatinine Is Associated with Low Bone Mineral Density in Subjects without Overt Nephropathy.
abstract: BACKGROUND
  Low skeletal muscle mass is associated with deterioration of bone mineral density. Because serum creatinine can serve as a marker of muscle mass, we evaluated the relationship between serum creatinine and bone mineral density in an older population with normal renal function.
  
  
  METHODS
  Data from a total of 8,648 participants (4,573 men and 4,075 postmenopausal women) aged 45-95 years with an estimated glomerular filtration rate >60 ml/min/1.73 m2 were analyzed from the Fourth Korea National Health and Nutrition Examination Survey (2008-2010). Bone mineral density (BMD) and appendicular muscle mass (ASM) were measured using dual-energy X-ray absorptiometry. Receiver operating characteristic curve analysis revealed that the cut points of serum creatinine for sarcopenia were below 0.88 mg/dl in men and 0.75 mg/dl in women. Subjects were divided into two groups: low creatinine and upper normal creatinine according to the cut point value of serum creatinine for sarcopenia.
  
  
  RESULTS
  In partial correlation analysis adjusted for age, serum creatinine was positively associated with both BMD and ASM. Subjects with low serum creatinine were at a higher risk for low BMD (T-score ≤ -1.0) at the femur neck, total hip and lumbar spine in men, and at the total hip and lumbar spine in women after adjustment for confounding factors. Each standard deviation increase in serum creatinine was significantly associated with reduction in the likelihood of low BMD at the total hip and lumbar spine in both sexes (men: odds ratio (OR) = 0.84 [95% CI = 0.74-0.96] at the total hip, OR = 0.8 [95% CI = 0.68-0.96] at the lumbar spine; women: OR = 0.83 [95% CI = 0.73-0.95] at the total hip, OR=0.81 [95% CI = 0.67-0.99] at the lumbar spine).
  
  
  CONCLUSIONS
  Serum creatinine reflected muscle mass, and low serum creatinine was independently associated with low bone mineral density in subjects with normal kidney function.
authors.affiliation: Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Ilsan-Dong, Wonju-Si, Gangwon-Do, Korea.
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Huh
authors.affiliation: Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Ilsan-Dong, Wonju-Si, Gangwon-Do, Korea.
authors.forename: Soo In
authors.initials: SI
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Ilsan-Dong, Wonju-Si, Gangwon-Do, Korea.
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Ilsan-Dong, Wonju-Si, Gangwon-Do, Korea.
authors.forename: Choon Hee
authors.initials: CH
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Ilsan-Dong, Wonju-Si, Gangwon-Do, Korea.
authors.forename: Jang Yel
authors.initials: JY
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Ilsan-Dong, Wonju-Si, Gangwon-Do, Korea.
authors.forename: Mi Young
authors.initials: MY
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology*; D003404:Creatinine / Q000097:blood*; D005260:Female; D005272:Femur Neck; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000453:epidemiology; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D010024:Osteoporosis / Q000097:blood* / Q000453:epidemiology; D056910:Republic of Korea / Q000453:epidemiology; D055948:Sarcopenia / Q000097:blood / Q000453:epidemiology
chemical_list: D003404:Creatinine