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Risk factors for the comorbidity of osteoporosis/osteopenia and kidney stones: a cross-sectional study

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Abstract

Summary

Low femoral neck bone mineral density (BMD) was associated with the increased risk of kidney stones. Low dietary magnesium intake and increased serum alkaline phosphatase were associated with the increased risk of low femoral neck BMD in kidney stone formers.

Purpose

To evaluate whether low femoral neck bone mineral density (BMD) was associated with a higher risk of kidney stones, and identify risk factors for the comorbidity of osteoporosis/osteopenia and kidney stones.

Methods

We analyzed individuals aged ≥ 20 years from National Health and Nutrition Examination Survey 2007–2020 data. Osteoporosis/osteopenia is defined as any T-score < −1.0 of femoral neck, total femoral, and mean lumbar spine (L1–L4) BMD. Dietary intakes (sodium, potassium, magnesium, calcium, phosphorus, calcium/phosphorus, vitamin D (25OHD2+25OHD3)) and serum parameters (sodium, potassium, calcium, phosphorus, bicarbonate, vitamin D, alkaline phosphatase (ALP)) were screened for identifying risk factors for the comorbidity.

Results

The prevalence of comorbidity of osteoporosis/osteopenia and kidney stones was 4.82%. Femoral neck BMD T-score was negatively associated with the prevalence of kidney stones (n=11,864). Dietary magnesium intake, serum phosphorus, and bicarbonate were negatively associated with the comorbidity prevalence, and serum ALP was positively associated with the comorbidity prevalence (n=6978). Additionally, there remain significant associations of dietary magnesium intake, serum ALP, and bicarbonate with not only femoral neck BMD T-score (n=11331), but also the prevalence of kidney stones (n=23,111) in general population. Furthermore, dietary magnesium intake was positively correlated to femoral neck BMD T-score in stone formers (SFs), while serum ALP was negatively correlated to femoral neck BMD T-score in SFs (n=1163).

Conclusion

Low femoral neck BMD was closely associated with an increased risk of kidney stones. Low magnesium intake and increased serum ALP were associated with the increased risk of the comorbidity, as well as indicative of low femoral neck BMD T-score in SFs, which offered a clue to further clarify the mechanism leading to paradoxical calcification of bone resorption and kidney stones, and had the potential to perform personalized diagnostic workup for low BMD in SFs.

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Data availability

All raw data are available on the NHANES and CDC website.

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Funding

This work was supported by Central South University Independent Exploration and Innovation Project for Graduate Students (2021zzts0348 to Zewu Zhu) and Graduate Innovation Project of Hunan Province (CX20210358 to Zewu Zhu).

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Authors and Affiliations

  1. Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China

    Zewu Zhu, Minghui Liu, Youjie Zhang, Jian Wu, Meng Gao, Fang Huang & Hequn Chen

  2. Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China

    Maolan Wu

  3. National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China

    Zewu Zhu & Maolan Wu

  4. Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, USA

    Zewu Zhu

  5. Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China

    Ting Lei

  6. Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Maolan Wu

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  1. Zewu Zhu
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Contributions

Conceptualization: Z. Z. and M. W.; data curation: Z. Z., M. L., Y. Z., J. W., and M. G.; methodology: Z. Z. and M. W.; project administration: H. C. and M. W.; software: Z. Z., M. L., T. L., and F. H.; validation: Z. Z., M. L., T. L., and F. H.; writing—original draft: Z. Z.; writing—review and editing: H. C. and M. W.

Corresponding author

Correspondence to Maolan Wu.

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The survey protocol was approved by National Center for Health Statistics Ethics Review Board, and written informed consent was obtained from all participants.

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Zhu, Z., Liu, M., Zhang, Y. et al. Risk factors for the comorbidity of osteoporosis/osteopenia and kidney stones: a cross-sectional study. Arch Osteoporos 18, 128 (2023). https://doi.org/10.1007/s11657-023-01338-3

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