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Urine albumin levels unrelated to incident fracture risk
The risk for clinical incident fracture is not associated with urine albumin levels, but urine albumin levels may be related to the rate of hip bone loss in older men, researchers reported.
Howard A. Fink, MD, MPH, of the Veterans Affairs Health Care System and School of Public Health, University of Minnesota in Minneapolis, and colleagues evaluated data from the Osteoporotic Fractures in Men (MrOS) study on 2,982 men (mean age at baseline visit, 76.4 years; 90.6% white) to determine the association of elevated urine albumin with subsequent fractures and annualized rate of hip bone loss. The albumin-to-creatinine ratio (ACR) was collected at the 2003 to 2005 visit. Follow-up was conducted for a mean of 8.7 years.
Overall, 9.4% of participants had albuminuria (ACR 30 mg/g), and 1% had macroalbuminuria (ACR 300 mg/g).
Through follow-up, 20% of participants had an incident clinical fracture, and 9.6% had an incident major osteoporotic fracture, including 4.2% with an incident hip fracture, 3.1% with an incident clinical vertebral fracture and 14.8% with an incident nonhip, nonvertebral fracture. The risk for incident clinical fracture (HR = 0.99; 95% CI, 0.9-1.08) and incident major osteoporotic fracture (HR = 0.98; 95% CI, 0.86-1.13) were not statistically significantly associated with log-transformed ACR after adjustment for age, race and study site.
The mean total hip bone mineral density loss per year was 0.4% among men with available ACR measures. The annual rate of total hip BMD loss was higher among men with albuminuria compared with those with albuminuria after adjustment for age, race and study site (–0.21% difference in annual rate of loss; P = .02). The rate of annual hip bone loss was also higher among participants with macroalbuminuria compared with those without albuminuria (–1.8% more annual loss; P < .001).
“We found no independent association of a one-time measure of urine albumin with risk of incident fracture in older men,” the researchers wrote. “We found that increased urine albumin levels were associated with a very small, though significant increase in the rate of annualized hip bone loss. Though analyses in the small subset of men with macroalbuminuria suggested that they may have a clinically meaningful greater rate of hip bone loss, and possibly a higher fracture rate, there were too few men with macroalbuminuria for these fracture results to be considered reliable.” – by Amber Cox
Disclosure: Fink reports no relevant financial disclosure. One researcher reports financial ties with Eli Lilly and Merck.