Skip to main content
main-content

01.03.2012 | Original Article | Ausgabe 3/2012

Osteoporosis International 3/2012

Renal function and nonvertebral fracture risk in multiethnic women: the Women’s Health Initiative (WHI)

Zeitschrift:
Osteoporosis International > Ausgabe 3/2012
Autoren:
K. E. Ensrud, K. Barbour, M. T. Canales, M. E. Danielson, R. M. Boudreau, D. C. Bauer, A. Z. LaCroix, A. Ishani, R. D. Jackson, J. A. Robbins, J. A. Cauley
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00198-011-1667-1) contains supplementary material, which is available to authorized users.

Abstract

Summary

To examine the association between renal function and fracture in multiethnic women, we studied postmenopausal women enrolled in the Women’s Health Initiative. Postmenopausal White women with mild renal dysfunction were at increased risk of nonvertebral fracture; this association was at least partially explained by effects of renal dysfunction on chronic inflammation. Reduced renal function appeared to increase fracture risk among Black women, but there was little evidence to support this association among other racial/ethnic groups.

Introduction

The purpose of this study was to determine whether renal function is associated with fracture risk within racial/ethnic groups.

Methods

A nested case–control study was conducted among 93,673 postmenopausal women; incident nonvertebral fractures were identified in 362 Black, 183 Hispanic, 110 Asian, and 45 American-Indian women. A random sample of 395 White women with incident nonvertebral fracture was chosen. One nonfracture control for each case was selected (matched on age, race/ethnicity, and blood draw date). Cystatin C levels were measured using baseline serum, and estimated glomerular filtration rate calculated (eGFRcys-c).

Results

Each 1 SD increase in cystatin C was associated with a 1.2-fold increased risk of fracture among White women (adjusted odds ratios [OR], 1.23; 95% confidence intervals [CI], 1.04–1.46). The OR of fracture was 1.16 (95% CI, 0.85–1.58) among women with eGFRcys-c 60–90 mL/min/1.73m2 and 2.46 (95% CI, 1.16–5.21) among those with eGFRcys-c <60 mL/min/1.73m2 compared to the reference group (eGFRcys-c >90 mL/min/1.73m2) (p trend = 0.05). The association was reduced after adjustment for cytokine TNFα soluble receptors (OR, 1.62; 95% CI, 0.59–4.46 for eGFRcys-c <60 mL/min/1.73 m2). Among Blacks, there was an association between cystatin C and fracture risk (OR per 1 SD increase, 1.15; 95% CI, 1.00–1.32); after adjustment, this association was only modestly attenuated, but no longer statistically significant. There was no evidence of significant associations among Hispanic, Asian, or American-Indian women.

Conclusion

Postmenopausal White women with mild renal dysfunction are at increased risk of nonvertebral fracture. Effects of renal function on chronic inflammation may mediate this association. Reduced renal function may increase fracture risk among Black women, but there was little evidence to support this association among other racial/ethnic groups.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

Zusatzmaterial
Nur für berechtigte Nutzer zugänglich
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 3/2012

Osteoporosis International 3/2012 Zur Ausgabe

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise