TY - JOUR
T1 - Bone mineral density and the risk of kidney disease in patients with type 1 diabetes
AU - Hauge, Sabina Chaudhary
AU - Hjortkjær, Henrik Øder
AU - Persson, Frederik
AU - Theilade, Simone
AU - Frost, Morten
AU - Jørgensen, Niklas Rye
AU - Rossing, Peter
AU - Hansen, Ditte
N1 - Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.
PY - 2025/2
Y1 - 2025/2
N2 - AIM: To explore the association between bone disorder and the risk for progression of diabetic kidney disease (DKD) in persons with type 1 diabetes mellitus (T1DM).METHODS: In this prospective cohort study the association between bone mineral density (BMD), bone-derived factors (sclerostin, Dickkopf-1, and osteoprotegerin (OPG)), and four outcomes were investigated: 1) progression of albuminuria; 2) decline in estimated glomerular filtration rate (eGFR) ≥30 %; 3) kidney failure (KF); and 4) a composite kidney outcome consisting of at least one of the outcomes.RESULTS: In 318 participants (median follow-up time 5.5 years) patients with osteoporosis (BMD with T-score < -2.5) had increased risk of eGFR decline: hazard ratio (HR) 2.56 (95 % CI 1.06-6.19, p = 0.04), KF: HR 9.92 (95 % CI 1.16-84.95, p = 0.04), and the composite kidney outcome: HR 2.42 (95 % CI 1.18-4.96, p = 0.02). Patients with high OPG had increased risk of eGFR decline, KF, and the composite outcome, compared to patients with low OPG in unadjusted analysis. No bone-derived factor was associated with any outcome in adjusted analyses.CONCLUSIONS: In patients with T1DM low BMD was associated with progression of DKD, suggesting an interaction between bone and kidney.
AB - AIM: To explore the association between bone disorder and the risk for progression of diabetic kidney disease (DKD) in persons with type 1 diabetes mellitus (T1DM).METHODS: In this prospective cohort study the association between bone mineral density (BMD), bone-derived factors (sclerostin, Dickkopf-1, and osteoprotegerin (OPG)), and four outcomes were investigated: 1) progression of albuminuria; 2) decline in estimated glomerular filtration rate (eGFR) ≥30 %; 3) kidney failure (KF); and 4) a composite kidney outcome consisting of at least one of the outcomes.RESULTS: In 318 participants (median follow-up time 5.5 years) patients with osteoporosis (BMD with T-score < -2.5) had increased risk of eGFR decline: hazard ratio (HR) 2.56 (95 % CI 1.06-6.19, p = 0.04), KF: HR 9.92 (95 % CI 1.16-84.95, p = 0.04), and the composite kidney outcome: HR 2.42 (95 % CI 1.18-4.96, p = 0.02). Patients with high OPG had increased risk of eGFR decline, KF, and the composite outcome, compared to patients with low OPG in unadjusted analysis. No bone-derived factor was associated with any outcome in adjusted analyses.CONCLUSIONS: In patients with T1DM low BMD was associated with progression of DKD, suggesting an interaction between bone and kidney.
KW - Bone mineral density
KW - Chronic kidney disease
KW - Dickkopf-1
KW - Osteoprotegerin
KW - Sclerostin
KW - Type 1 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85212534064&partnerID=8YFLogxK
U2 - 10.1016/j.jdiacomp.2024.108927
DO - 10.1016/j.jdiacomp.2024.108927
M3 - Journal article
C2 - 39708433
SN - 1056-8727
VL - 39
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
IS - 2
M1 - 108927
ER -