Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea.
Institute for Clinical and Translational Research, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea.
J Bone Miner Res. 2020 Jul;35(7):1313-1321. doi: 10.1002/jbmr.3997. Epub 2020 Mar 24.
This study was conducted to examine the association between renal function and hip fracture. We followed up 352,624 Korean adults, who participated in health examinations during 2009-2010 until 2013. Kidney function was assessed by creatinine-based estimated glomerular filtration rate (eGFR) and albuminuria using urine reagent strip results. The incidence of hip fracture was examined by hospital discharge records. Hazard ratios (HRs) for hip fracture were calculated using Cox proportional hazard models after adjusting for multiple confounders. During a mean follow-up of 4.0 years, 1177 participants suffered a hip fracture. Lower eGFR and more severe albuminuria were associated with a higher risk of hip fracture. The HRs for hip fracture were 1.89 (95% confidence interval [CI] 1.47-2.43) and 3.75 (95% CI 2.30-6.11) among participants with eGFRs of 30 to 44 and 15 to 29 mL/min/1.73m relative to those with an eGFR ≥60 mL/min/1.73m , respectively. The HRs were 1.30 (95% CI 1.02-1.65) for moderate albuminuria and 1.58 (95% CI 1.07-2.35) for severe albuminuria (p for trend = 0.002). Participants with albuminuria had a higher risk of hip fracture than those without albuminuria, even when they belonged to the same eGFR category (HR = 1.75 versus 3.30 for an eGFR of 30 to 44 mL/min/1.73m ; HR = 2.72 versus 7.84 for an eGFR of 15 to 29 mL/min/1.73m ). The effects of each 10 mL/min/1.73m decrease in eGFR were stronger with advancing albuminuria severity (p = 0.016). In conclusion, both low eGFR and albuminuria were risk factors for incident hip fracture in Korean adults. Moreover, these factors exerted a synergistic effect on the risk of hip fracture. © 2020 American Society for Bone and Mineral Research.
本研究旨在探讨肾功能与髋部骨折之间的关系。我们对 352624 名韩国成年人进行了随访，这些人在 2009 年至 2010 年期间参加了健康检查，并一直随访至 2013 年。肾功能通过基于肌酐的估算肾小球滤过率（eGFR）和尿试剂带结果评估白蛋白尿。通过医院出院记录检查髋部骨折的发生率。使用 Cox 比例风险模型调整多个混杂因素后，计算髋部骨折的风险比（HR）。在平均 4.0 年的随访期间，有 1177 名参与者发生髋部骨折。较低的 eGFR 和更严重的白蛋白尿与髋部骨折风险增加相关。eGFR 为 30 至 44 和 15 至 29 mL/min/1.73m 的参与者发生髋部骨折的 HR 分别为 1.89（95%置信区间[CI]1.47-2.43）和 3.75（95%CI2.30-6.11），与 eGFR≥60 mL/min/1.73m 的参与者相比。中度白蛋白尿的 HR 为 1.30（95%CI1.02-1.65），重度白蛋白尿的 HR 为 1.58（95%CI1.07-2.35）（趋势检验 p = 0.002）。即使在属于相同 eGFR 类别时，有白蛋白尿的参与者发生髋部骨折的风险也高于无白蛋白尿的参与者（eGFR 为 30 至 44 mL/min/1.73m 的 HR = 1.75；eGFR 为 15 至 29 mL/min/1.73m 的 HR = 2.72）。随着白蛋白尿严重程度的增加，eGFR 每降低 10 mL/min/1.73m 的影响更强（p = 0.016）。总之，在韩国成年人中，低 eGFR 和白蛋白尿都是髋部骨折发生的危险因素。此外，这些因素对髋部骨折的风险有协同作用。2020 年美国骨与矿物质研究学会版权所有。
