Association between urine albumin to creatinine ratio and bone mineral density: a cross-sectional study.

ABSTRACT

BACKGROUND: Studies on the association between urinary albumin to creatinine ratio (ACR) and bone mineral density (BMD) are still controversial. AIMS: This study investigated the association between ACR and BMD in the general US population. METHODS: This cross-sectional study identified 2007 individuals aged 40 or above years with complete and valid data on urinary albumin to creatinine ratio (ACR) and femoral neck, total femur and lumbar spine BMD from the National Health and Nutrition Examination Survey 2013-2014. ACR was directly measured with established methods. BMDs were measured by dual-energy X-ray absorptiometry (DXA). After adjusting for multiple covariates, we used general linear model (GLM) to compare the mean of BMD between the quartiles of ACR. RESULTS: The mean age of participants in this study was 54.6 ± 11.3 years; 52.6% of them were female. ACR was negatively associated with BMD at femoral neck, total femur and lumbar spine (all P < 0.05). After adjusting for covariates, higher level of ACR quartile was associated with lower femoral neck BMD (P for trend = 0.032), but with not total femur and lumbar spine BMD (all P for trend > 0.05)). CONCLUSION: ACR was negatively associated with femoral neck BMD in the general US population. Future studies are warranted to confirm our results.