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. 2025 Feb;39(2):108927.
doi: 10.1016/j.jdiacomp.2024.108927. Epub 2024 Dec 5.

Bone mineral density and the risk of kidney disease in patients with type 1 diabetes

Sabina Chaudhary Hauge  1 , Henrik Øder Hjortkjær  2 , Frederik Persson  2 , Simone Theilade  2 , Morten Frost  3 , Niklas Rye Jørgensen  4 , Peter Rossing  5 , Ditte Hansen  6
Affiliations
Free article

Bone mineral density and the risk of kidney disease in patients with type 1 diabetes

Sabina Chaudhary Hauge et al. J Diabetes Complications. 2025 Feb.
Free article

Abstract

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.

Keywords: Bone mineral density; Chronic kidney disease; Dickkopf-1; Osteoprotegerin; Sclerostin; Type 1 diabetes.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Ditte Hansen reports financial support was provided by Augustinus Foundation. Peter Rossing reports financial support was provided by Steno Diabetes Center Copenhagen. Morten Frost reports a relationship with Novo Nordisk that includes: consulting or advisory. Morten Frost reports a relationship with Novo Nordisk that includes: equity or stocks. Morten Frost reports a relationship with Eli Lilly and Company that includes: equity or stocks. Morten Frost reports a relationship with Ascendis Pharma that includes: equity or stocks. Peter Rossing reports a relationship with Astra Zeneca Abbott that includes: funding grants. Peter Rossing reports a relationship with Bayer that includes: funding grants. Peter Rossing reports a relationship with Novo Nordisk that includes: funding grants. Ditte Hansen reports a relationship with Novo Nordisk Foundation that includes: funding grants. Ditte Hansen reports a relationship with Augustinus Foundation that includes: funding grants. Ditte Hansen reports a relationship with Vifor Pharma that includes: funding grants. Ditte Hansen reports a relationship with Gedeon Richter that includes: funding grants. Ditte Hansen reports a relationship with UCB Nordic that includes: consulting or advisory. Ditte Hansen reports a relationship with GSK that includes: consulting or advisory. Ditte Hansen reports a relationship with Astra Zeneca that includes: consulting or advisory. Receiving medicine and placebo free of charge from Novo Nordisk A/S for an investigator-initiated trial, MF. Being an chair on an expert committee at the Danish Medicines Council, MF. Receiving honoraria to Steno Diabetes Center Copenhagen from Astra Zeneca, Bayer, Boehringer Ingelheim, Novo Nordisk, Gilead, Novartis, PR. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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