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 Albuminuria and Risk of Nonvertebral Fractures

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Registration date : 2007-09-19

PostSubject: Albuminuria and Risk of Nonvertebral Fractures   Fri Sep 21, 2007 12:12 am

Albuminuria and Risk of Nonvertebral Fractures



Lone Jørgensen, PhD; Trond Jenssen, MD, PhD; Luai Ahmed, MD, PhD;
Åshild Bjørnerem, MD; Ragnar Joakimsen, MD, PhD; Bjarne K. Jacobsen, PhD



Arch Intern Med. 2007;167:1379-1385.



Background Individuals with end-stage renal disease are at higher risk
of fractures compared with subjects in the general population. We
examined whether elevated albumin-creatinine ratios (ACRs) were
associated with nonvertebral fractures in subjects without diabetes or
macroalbuminuria.



Methods A total of 4497 subjects (2267 men and 2230 women) 55
to 74 years old at baseline were followed for a mean of 8.4 years.
Measurements of ACR, height, weight, blood pressure, lipids, serum
creatinine, and bone mineral density were performed, and information
about smoking and drinking habits, physical activity, prevalent
diseases, and use of medication was collected before the start of
follow-up. Nonvertebral fractures were registered during follow-up.



Results A total of 135 men and 382 women sustained a new
nonvertebral fracture. For a 1-SD higher value for the log-transformed
ACR, the relative risk for a fracture was 1.01 in men (P = .94, after
multiple adjustments) and 1.15 in women (P = .005). Women with ACRs in
the highest quartile had a 71% higher risk of nonvertebral fractures
compared with women with ACRs in the lowest quartile (P value for
linear trend over the quartiles, .001). Bone mineral density tended to
be lower with higher ACRs in both sexes, but this did not explain the
increased fracture risk in women.



Conclusion Albumin-creatinine ratio was associated with
nonvertebral fractures in women without diabetes or macroalbuminuria
but not in men.





Author Affiliations: Institutes of Community Medicine (Drs
Jørgensen, Ahmed, Bjørnerem, and Jacobsen) and Clinical Medicine (Drs
Jenssen and Joakimsen), University of Tromsø, Tromsø, Norway;
Departments of Physiotherapy (Dr Jørgensen) and Internal Medicine (Dr
Joakimsen), University Hospital of Tromsø; and Medical Department,
Division of Nephrology, Rikshospitalet, Oslo, Norway (Dr Jenssen).
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