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Effect of declining renal function on bone density in aging women

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Summary

The factors that are responsible for trabecular bone loss in aging women are not completely understood. To evaluate declining renal function as a possible factor, we studied 19 Caucasian women (average age 67) who were from 6 to 41 years postmenopausal. Trabecular bone density was quantitated by computerized tomography of the spine. Serum calcium, phosphorus, and creatinine were normal in all subjects. Creatinine clearance averaged 74 ml/min (range 38–122), decreased with age (r=−0.60,P=0.003), and was inversely related to serum creatinine (r=−0.51,P=0.01). Bivariate regression demonstrated that bone density decreased with age (r=−0.59,P=0.004); controlling for the effect of creatinine clearance weakened this correlation to r=−0.45 (P=0.03); controlling additionally for 1,25-dihydroxyvitamin D [1,25(OH)2D] and parathyroid hormone (PTH) reduced the correlation coefficient to r=−0.34 (P=0.11). Bone density also decreased in direct proportion to the decrement in creatinine clearance (r=0.44,P=0.03); controlling for the effects of 1,25(OH)2D and PTH reduced this correlation coefficient to r=0.34 (P=0.11). These results suggest that occult renal insufficiency may contribute to bone loss in aging women, and that this effect may be mediated in part by 1,25(OH)2D and PTH. In this age group renal function should be assessed by measuring creatinine clearance rather than the serum creatinine concentration since renal insufficiency can be masked by apparently normal circulating creatinine levels.

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References

  1. Riggs BL, Melton LJ III (1986) Involutional osteoporosis. N Engl J Med 314:1676–1686

    Article  PubMed  CAS  Google Scholar 

  2. Cann CE, Genant HK, Kolb FO, Ettinger B (1985) Quantitative computed tomography for prediction of vertebral fracture risk. Bone 6:1–7

    Article  PubMed  CAS  Google Scholar 

  3. Marcus R, Kosek J, Pfefferbaum A, Horning S (1983) Agerelated loss of trabecular bone in premenopausal women: a biopsy study. Calcif Tissue Int 35:406–409

    Article  PubMed  CAS  Google Scholar 

  4. McBrom RJ, Hayes WC, Edwards WT, Goldberg RP, White AA (1985) Prediction of vertebral body compressive fracture using quantitative computed tomography. J Bone Joint Surg 67A:1206–1214

    Google Scholar 

  5. Lindsay R, Aitken JM, Anderson JB, Hart DM, MacDonald E, Clarke AC (1976) Long-term prevention of postmenopausal osteoporosis by oestrogen. Lancet 1:1038–1041

    Article  PubMed  CAS  Google Scholar 

  6. Riggs BL, Wahner HW, Melton LJ, Richelson LS, Judd HL, Offord KP (1986) Rates of bone loss in the appendicular and axial skeletons of women. J Clin Invest 77:1487–1491

    PubMed  CAS  Google Scholar 

  7. Kampmann JP, Sierbaek-Nielsen K, Kristensen M, Hansen JM (1971) Aldersbetingede variationer I urinkreatinin gg endogen kreatininclearance. Ugeskrift For Laeger 133:2369–2372

    PubMed  CAS  Google Scholar 

  8. Marcus R, Madvig P, Young G (1984) Age-related changes in parathyroid hormone and parathyroid hormone action in normal humans. J Clin Endocrinol Metab 58:223–230

    PubMed  CAS  Google Scholar 

  9. Morgan DB, Dillon S, Payne RB (1978) The assessment of glomerular function: creatinine clearance or plasma creatinine? Postgrad Med J 54:302–310

    PubMed  CAS  Google Scholar 

  10. Rowe JW, Andres R, Tobin JD, Norris AH, Shock NW (1976) The effect of age on creatinine clearance in men: a cross-sectional and longitudinal study. J Gerontol 31:155–163

    PubMed  CAS  Google Scholar 

  11. Tsai KS, Heath H III, Kumar R, Riggs BL (1984) Impaired vitamin D metabolism with aging in women: possible role in pathogenesis of senile osteoporosis. J Clin Invest 73:1668–1672

    PubMed  CAS  Google Scholar 

  12. Francis RM, Peacock M, Barkworth SA (1984) Renal impairment and its effects on calcium metabolism in elderly women. Age Ageing 13:14–20

    Article  PubMed  CAS  Google Scholar 

  13. Wilson L, Felsenfeld A, Drezner MK, Llach F (1985) Altered divalent ion metabolism in early renal failure: role of 1,25(OH)2D. Kidney Int 27:565–5733

    PubMed  CAS  Google Scholar 

  14. Johnston CC, Hui SL, Witt RM, Appledorn R, Baker RS, Langcope C (1985) Early menopausal changes in bone mass and sex steroids. J Clin Endocrinol Metab 61:905–911

    PubMed  CAS  Google Scholar 

  15. Reinhardt T, Horst R, Orf J, Hollis B (1984) A microassay for 1,25-dihydroxyvitamin D not requiring high performance liquid chromatography: application to clinical studies. J Clin Endocrinol Metab 58:91–98

    PubMed  CAS  Google Scholar 

  16. Buchanan JR, Santen RJ, Cavaliere A, Cauffman SW, Greer RB, Demers LM (1986) Interaction between parathyroid hormone and endogenous estrogen in normal women. Metabolism 35:489–494

    Article  PubMed  CAS  Google Scholar 

  17. Buchanan JR, Myers C, Greer RB, Lloyd T, Varano LA (1987) Assessment of vertebral fracture risk in menopausal women. J Bone Joint Surg 69-A:212–218

    Google Scholar 

  18. Reinbold WD, Genant HK, Reiser UJ, Harris ST, Ettinger B (1986) Bone mineral content in early-postmenopausal and postmenopausal osteoporotic women: comparison of measurement methods. Radiology 160:469–478

    PubMed  CAS  Google Scholar 

  19. Rosenthal DI, Ganott MA, Wyshak G, Slovik DM, Dopplet SH, Neer RM (1985) Quantitative computed tomography for spinal density measurement factors affecting precision. Invest Radiol 20:306–310

    Article  PubMed  CAS  Google Scholar 

  20. Richardson ML, Genant HK, Cann CE, Ettinger B, Gordan GS, Kolb FO, Reiser UJ (1985) Assessment of metabolic bone diseases by quantitative computed tomography. Clin Orthop Rel Res 195:224–238

    Google Scholar 

  21. Laval-Jeantet AM, Cann CE, Roger B, Dallant P (1984) A postprocessing dual energy technique for vertebral CT densitometry. J Comput Assist Tomogr 8:1164–1167

    Article  PubMed  CAS  Google Scholar 

  22. Nie NH, Hull CH, Jenkins JG, Steinbrenner K, Bent DH (1975) Statistical package for the social sciences (SPSS), McGraw-Hill, New York.

    Google Scholar 

  23. Allen A (1982) SAS user's guide. SAS Institute, Inc., Basics ed. Cary, North Carolina

    Google Scholar 

  24. Brautbar N (1986) Osteoporosis: is 1,25-(OH)2D3 of value in treatment? Nephron 44:161–166

    Article  PubMed  CAS  Google Scholar 

  25. Orwoll ES, Meier DE (1986) Alterations in calcium, vitamin D, and parathyroid hormone physiology in normal men with aging: relationship to the development of senile osteopenia. J Clin Endocrinol Metab 63:1262–1269

    PubMed  CAS  Google Scholar 

  26. Gallagher JC, Riggs BL, Eisman J, Hamstra A, Arnaud SB, DeLuca HF (1979) Intestinal calcium absorption and serum vitamin D metabolites in normal subjects and osteoporotic patients. J Clin Invest 64:729–736

    PubMed  CAS  Google Scholar 

  27. Manolagas SC, Culler FL, Howard JE, Brickman AS, Deftos LJ (1983) The cytoreceptor assay for 1,25-dihydroxyvitamin D and its application to clinical studies. J Clin Endocrinol Metab 56:751–760

    Article  PubMed  CAS  Google Scholar 

  28. Slovik DM, Adams JS, Neer RM, Holick MF, Potts JT (1981) Deficient production of 1,25-dihydroxyvitamin D in elderly osteoporotic patients. N Engl J Med 305:372–374

    Article  PubMed  CAS  Google Scholar 

  29. Gallagher JC, Riggs BL, Jerpbak CM, Arnaud CD (1980) The effect of age on serum immunoreactive parathyroid hormone in normal and osteoporotic women. J Lab Clin Med 95:373–385

    PubMed  CAS  Google Scholar 

  30. Insogna KL, Lewis AM, Lipinski BA, Bryant C, Baran DT (1981) Effect of age on serum immunoreactive parathyroid hormone and its biological effects. J Clin Endocrinol Metab 53:1072–1075

    PubMed  CAS  Google Scholar 

  31. Wiske PS, Epstein B, Bell NH, Quenner SF, Edmondson J, Johnston CC (1979) Increases in immunoreactive parathyroid hormone with age. N Engl J Med 300:1419–1421

    Article  PubMed  CAS  Google Scholar 

  32. Buchanan JR, Cauffman SW (1984) Secondary hyperparathyroidism in postmenopausal osteoporosis. Proc VIII Int Conf on Calcium-Regulating Hormones, Kobe, Japan, October 1983. In: Cohn DV, Fujita T, Potts JT, Talmage RV (eds) Endocrine control of bone and calcium metabolism, vol. 8A. Elsevier Science Publishing Co. Inc, New York

    Google Scholar 

  33. Adams ND, Gray RW, Lemann J (1979) The effects of oral CaCO3 loading and dietary calcium deprivation on plasma 1,25-dihydroxyvitamin D concentrations in healthy adults. J Clin Endocrinol Metab 48:1008–1016

    PubMed  CAS  Google Scholar 

  34. Norman DA, Fordtran JS, Brinkley LJ (1981) Jejunal and ileal adaptation to alterations in dietary calcium. J Clin Invest 67:1599–1603

    Article  PubMed  CAS  Google Scholar 

  35. Francis R, Peacock M, Taylor G, Storor J, Nordin B (1984) Calcium malabsorption in elderly women with vertebral fractures: evidence for resistance to the action of vitamin D metabolites on the bowel. Clin Science 66:103–107

    CAS  Google Scholar 

  36. Buchanan JR, Cauffman SW, Greer RB (1984) Relation of calcium-regulating hormones to the pathogenesis of postmenopausal osteoporosis. Proc Cophenhagen Int Symp on Osteoporosis, Copenhagen, Denmark, p 275

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Authors and Affiliations

  1. Division of Orthopaedie Surgery, The Milton S. Hershey Medical Center, The Pennsylvania State University, P.O. Box 850, 17033, Hershey, Pennsylvania, USA

    James R. Buchanan M.D., Cathleen A. Myers & Robert B. Greer III

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  1. James R. Buchanan M.D.
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  2. Cathleen A. Myers
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  3. Robert B. Greer III
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Buchanan, J.R., Myers, C.A. & Greer, R.B. Effect of declining renal function on bone density in aging women. Calcif Tissue Int 43, 1–6 (1988). https://doi.org/10.1007/BF02555161

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  • DOI: https://doi.org/10.1007/BF02555161

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