TY - JOUR
T1 - Associations Between Surrogates of Skeletal Muscle Mass and History of Bone Fracture in Patients with Chronic Kidney Disease
T2 - The Fukuoka Kidney disease Registry (FKR) Study
AU - Yamada, Shunsuke
AU - Tanaka, Shigeru
AU - Arase, Hokuto
AU - Hiyamuta, Hiroto
AU - Yoshizumi, Eriko
AU - Tokumoto, Masanori
AU - Nakano, Toshiaki
AU - Tsuruya, Kazuhiko
AU - Kitazono, Takanari
N1 - Funding Information:
We would like to thank all the doctors and medical staff who participated in the FKR Study. Steering Committee and Principal Collaborators of the FKR Study Group: Satoru Fujimi (Fukuoka Renal Clinic), Hideki Hirakata (Fukuoka Renal Clinic), Tadashi Hirano (Hakujyuji Hospital), Tetsuhiko Yoshida (Hamanomachi Hospital), Takashi Deguchi (Hamanomachi Hospital), Hideki Yotsueda (Harasanshin Hospital), Kiichiro Fujisaki (Iizuka Hospital), Keita Takae (Japanese Red Cross Fukuoka Hospital), Koji Mitsuiki (Japanese Red Cross Fukuoka Hospital), Akinori Nagashima (Japanese Red Cross Karatsu Hospital), Ritsuko Katafuchi (Kano Hospital), Hidetoshi Kanai (Kokura Memorial Hospital), Kenji Harada (Kokura Memorial Hospital), Tohru Mizumasa (Kyushu Central Hospital), Takanari Kitazono (Kyushu University), Toshiaki Nakano (Kyushu University), Toshiharu Ninomiya (Kyushu University), Kumiko Torisu (Kyushu University), Akihiro Tsuchimoto (Kyushu University), Shunsuke Yamada (Kyushu University), Hiroto Hiyamuta (Kyushu University), Shigeru Tanaka (Kyushu University), Dai Matsuo (Munakata Medical Association Hospital), Yusuke Kuroki (National Fukuoka-Higashi Medical Center), Hiroshi Nagae (National Fukuoka-Higashi Medical Center), Masaru Nakayama (National Kyushu Medical Center), Kazuhiko Tsuruya (Nara Medical University), Masaharu Nagata (Shin-eikai Hospital), Taihei Yanagida (Steel Memorial Yawata Hospital), Shotaro Ohnaka (Tagawa Municipal Hospital). We also thank Susan Furness, PhD, from Edanz Group (https://en-author-services.edanzgroup.com/ac ) for editing a draft of this manuscript.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2021/10
Y1 - 2021/10
N2 - Patients with chronic kidney disease (CKD) are at increased risks of both sarcopenia and fragility fractures. However, information on the association between skeletal muscle mass (SMM) and the risk of bone fractures in patients with CKD is lacking. We performed a cross-sectional analysis of 4146 patients with CKD using the baseline dataset of the Fukuoka Kidney disease Registry Study, as a multicenter, prospective cohort study of pre-dialysis CKD patients. The main measure was estimated SMM (eSMM) calculated using an equation validated by bioelectrical impedance analysis with two independent datasets of 100 and 81 CKD patients. The main outcome was historical bone fractures. The associations between sex-specific quartiles (Q1–Q4) of eSMM and fracture history were assessed by logistic regression analyses. The prevalence of a history of fractures increased and eSMM decreased with progressive CKD stages. Among the 4146 patients, 249 had prior bone fractures, including 111 patients in Q1 (lowest quartile), 65 in Q2, 46 in Q3, and 27 in Q4 (highest quartile). A multivariable-adjusted model revealed that patients in Q1 had a significantly higher odds ratio (95% confidence interval) for bone fracture history than those in Q4 (reference): Q1, 2.77 (1.32–5.80); Q2, 1.95 (1.05–3.65); and Q3, 1.57 (0.90–2.75) (P-value for trend < 0.001). Similar associations were obtained when other skeletal muscle surrogates were applied: serum creatinine to serum cystatin C and daily urinary creatinine excretion. These results suggest that a lower eSMM is associated with an increased prevalence of historical bone fractures in pre-dialysis CKD patients.
AB - Patients with chronic kidney disease (CKD) are at increased risks of both sarcopenia and fragility fractures. However, information on the association between skeletal muscle mass (SMM) and the risk of bone fractures in patients with CKD is lacking. We performed a cross-sectional analysis of 4146 patients with CKD using the baseline dataset of the Fukuoka Kidney disease Registry Study, as a multicenter, prospective cohort study of pre-dialysis CKD patients. The main measure was estimated SMM (eSMM) calculated using an equation validated by bioelectrical impedance analysis with two independent datasets of 100 and 81 CKD patients. The main outcome was historical bone fractures. The associations between sex-specific quartiles (Q1–Q4) of eSMM and fracture history were assessed by logistic regression analyses. The prevalence of a history of fractures increased and eSMM decreased with progressive CKD stages. Among the 4146 patients, 249 had prior bone fractures, including 111 patients in Q1 (lowest quartile), 65 in Q2, 46 in Q3, and 27 in Q4 (highest quartile). A multivariable-adjusted model revealed that patients in Q1 had a significantly higher odds ratio (95% confidence interval) for bone fracture history than those in Q4 (reference): Q1, 2.77 (1.32–5.80); Q2, 1.95 (1.05–3.65); and Q3, 1.57 (0.90–2.75) (P-value for trend < 0.001). Similar associations were obtained when other skeletal muscle surrogates were applied: serum creatinine to serum cystatin C and daily urinary creatinine excretion. These results suggest that a lower eSMM is associated with an increased prevalence of historical bone fractures in pre-dialysis CKD patients.
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U2 - 10.1007/s00223-021-00851-2
DO - 10.1007/s00223-021-00851-2
M3 - Article
C2 - 33905004
AN - SCOPUS:85104854675
SN - 0171-967X
VL - 109
SP - 393
EP - 404
JO - Calcified Tissue International
JF - Calcified Tissue International
IS - 4
ER -
