Pan Bo-Lin, Loke Song-Seng
Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, Niaosong District, Kaohsiung, Taiwan.
PLoS One. 2018 Jan 10;13(1):e0190985. doi: 10.1371/journal.pone.0190985. eCollection 2018.
The relationship between decreased bone mineral density (BMD) and chronic kidney disease (CKD) is controversial. The associations among metabolic syndrome (MetS), serum uric acid and CKD are also unclear. We aimed to investigate the relationship between decreased BMD, MetS, serum uric acid and CKD in a general population.
A total of 802 subjects who visited a medical center in Southern Taiwan and underwent a BMD measured by dual-energy X-ray absorptiometry (DEXA) during a health examination were enrolled in this retrospective cross-sectional study. Either osteopenia or osteoporosis was defined as decreased BMD. CKD was defined as the estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73m2. Simple and multivariate logistic regression analyses were used to investigate the association between variables, decreased BMD and CKD.
Of the 802 subjects with a mean age of 54.4±10.2 years, the prevalence of decreased BMD was 62.9%, and CKD was 3.7%. Simple logistic analysis showed that sex (OR 3.50, 95% CI 1.21-10.12, p = 0.021), age (OR 1.14, 95% CI 1.07-1.21, p<0.001), BMI (OR 1.11, 95% CI 1.01-1.22, p = 0.028), waist circumference (OR 1.06, 95% CI 1.02-1.10, p = 0.002), SBP (OR 1.03, 95% CI 1.01-1.04, p = 0.003), DBP (OR 1.03, 95% CI 1.00-1.06, p = 0.030), HDL-C (OR 0.97, 95% CI 0.94-1.00, p = 0.026), uric acid (OR 1.84, 95% CI 1.49-2.27, p<0.001), metabolic syndrome (OR 2.68, 95% CI 1.29-5.67, p = 0.009), and decreased BMD (OR 3.998, 95% CI 1.38-11.57, p = 0.011) were significantly associated with CKD. Multivariate analysis showed that age (OR 1.05, 95% CI 1.03-1.07, p<0.001), decreased BMD (OR 0.64, 95% CI 0.45-0.91, p = 0.013), and uric acid (OR 1.40, 95% CI 1.24-1.59, p<0.001) were significantly independently associated with CKD.
Decreased BMD, uric acid and MetS were significantly associated with CKD.. Further large and prospective cohort studies are necessary to investigate whether management of osteoporosis, hyperuricemia, or MetS might prevent the progression of CKD.
骨矿物质密度（BMD）降低与慢性肾脏病（CKD）之间的关系存在争议。代谢综合征（MetS）、血清尿酸与CKD之间的关联也不明确。我们旨在调查普通人群中BMD降低、MetS、血清尿酸与CKD之间的关系。
本回顾性横断面研究纳入了802名到台湾南部一家医疗中心就诊并在健康检查期间接受双能X线吸收法（DEXA）测量BMD的受试者。骨量减少或骨质疏松被定义为BMD降低。CKD被定义为估算肾小球滤过率（eGFR）低于60 mL/min/1.73m²。采用单因素和多因素逻辑回归分析来研究变量、BMD降低与CKD之间的关联。
在这802名平均年龄为54.4±10.2岁的受试者中，BMD降低的患病率为62.9%，CKD的患病率为3.7%。单因素逻辑分析显示，性别（比值比[OR] 3.50，95%置信区间[CI] 1.21 - 10.12，p = 0.021）、年龄（OR 1.14，95% CI 1.07 - 1.21，p<0.001）、体重指数（BMI）（OR 1.11，95% CI 1.01 - 1.22，p = 0.028）、腰围（OR 1.06，95% CI 1.02 - 1.10，p = 0.
