Reduced creatinine clearance in primary osteoporosis in women.

ABSTRACT

We determined the relationship between bone mass and age, anthropometric variables, and serum and urine biochemical variables in 77 normal white women and 37 women with primary osteoporosis, 25 of whom had one or more vertebral compression fractures. Skeletal status was assessed by radiography of the hands with measurement of combined cortical thickness of the second metacarpal bones (CCT) or measurement of radial and lumbar bone density, or by both methods. Radial bone mineral content (RBMC) was measured by single-photon absorptiometry (SPA) and lumbar bone mineral density by dual-photon absorptiometry (DPA). Serum and urine biochemical variables were measured on days 6 and 7 of a controlled diet. In this mixed population of normal and osteoporotic women, we confirmed the strong positive correlation between creatinine clearance (Ccr) and bone mass that we previously reported in normal women. Multiple regression analysis showed that the relationship between Ccr and bone mass of the radius and lumbar spine was independent of age and body stature. Ccr was significantly lower in the 25 osteoporotic women with vertebral crush fractures than in age-matched normal women, and Ccr had predictive value for bone mass in individual subjects. The basis for the relationship between Ccr and bone mass has not been established. We excluded diminished production of 1,25-dihydroxyvitamin D as a result of declining renal function as a possible mechanism.