Correlation between glomerular filtration rate and osteoporosis in physical examination population

Objective To observe the changes of glomerular filtration rate (GFR) in osteoporosis in physical examination population, and analyze its related influencing factors.

Methods Patients aged 40 years and over who underwent physical examinations at the Health Management Center of Affiliated Hospital of Yangzhou University from January to December 2020 were retrospectively included. Male and female health examiners were divided into different groups according to the estimated glomerular filtration rate (eGFR). The eGFR ≥ 90 mL/(min·1.73 m²) indicated normal eGFR, while eGFR < 90 mL/(min·1.73 m²) indicated decreased eGFR. The equation based on serum creatinine (Scr) was used to calculate eGFR, and Pearson or Spearman correlation analysis was used to explore the correlations of eGFR with bone mineral density indicators. Multivariate Logistic regression analysis was used to study the influencing factors of osteopenia and osteoporosis.

Results A total of 6 776 people who underwent physical examinations were included, including 1 494(54.23%) females with normal eGFR and 1 261(45.77%) with decreased eGFR. Among males with physical examinations, 1 900(47.25%) had normal eGFR and 2 121 (52.75%) had decreased eGFR. The incidence rates of osteoporosis and osteopenia were 11.50% and 26.62%, respectively. Among males with physical examinations, the incidence rates of osteoporosis and osteopenia in males with decreased eGFR levels were 7.59% and 26.59%, respectively, and the incidence rates of osteoporosis and osteopenia in males with normal eGFR levels were 4.47% and 23.47%, respectively, and the differences were statistically significant (P < 0.05). Among females with physical examinations, the incidence rates of osteoporosis and osteopenia in females with decreased eGFR levels were 27.04% and 30.77%, respectively, and were 12.85% and 27.18%, respectively in females with normal eGFR, and the differences were statistically significant (P < 0.05). Correlation analysis showed that there was a significant negative correlation of bone mineral density of females and males with eGFR (P < 0.05). Multiple Logistic regression analysis showed that decreased eGFR was a risk factor for osteoporosis (OR=1.380, 95%CI, 1.061 to 1.796, P=0.016).

Conclusion The incidence rates of osteoporosis and osteopenia in middle-aged and elderly people undergoing physical examinations are significantly related to the decline of eGFR. Clinicians should pay more attention to the patients with decreased renal function in the population, and early screening is needed for the possibility of osteoporosis.