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The Longitudinal Effect of Impaired Kidney Function on Bone Mineral Density and the Association of Body Composition on Biomarkers of Kidney Function Among Afro-Caribbean Men of West African Ancestry

Egwuogu, Heartley (2013) The Longitudinal Effect of Impaired Kidney Function on Bone Mineral Density and the Association of Body Composition on Biomarkers of Kidney Function Among Afro-Caribbean Men of West African Ancestry. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Background: Chronic kidney disease (CKD) is a rising global health problem. African Americans bear a greater proportion of CKD burden compared to Caucasians. Little is known about the relationship of CKD with bone loss and body composition distribution with biomarkers of CKD in blacks.
Objective: The prevalence of CKD among Tobago black, African American and Caucasian men, aged 40 years and older were determined and compared. The risk factors of CKD, the association of body composition with biomarkers of CKD and the effect of CKD on longitudinal bone loss were examined among Tobago black males.
Methods: Tobago men were recruited from Tobago Island in 2004-2007. Counterparts from U.S were obtained from the National Health and Nutrition Examination Survey (NHANES) 2003-2006. Standardized serum creatinine, cystatin C and urinary albumin were measured using Jaffè reaction, Dade Behring nephelometer and fluorescent immunoassay respectively. Longitudinal Bone Mineral Density changes in trochanter, femoral neck and total hip from 2004/2007-2012 were measured using Dual X-Ray Absorptiomertry (DXA). Body composition was measured using DXA and Peripheral Quantitative Computed Tomography (PQCT). Covariates were assessed from questionnaires in 2004-2007.
Results: The prevalence of CKD was 19.7%, 23.4% and 19.7% in Tobago black, African American and Caucasian men respectively. Age, hypertension and diabetes were significantly associated with CKD in Tobago men. Lean body mass and calf muscle area were positively associated with serum creatinine. All adiposity measures were positively associated with cystatin C, but not with calf muscle area. There was consistent greater decline in BMD across quartiles of ACR, serum creatinine and cystatin C in trochanter, femoral neck and total hip bones. The rate of bone loss in Tobago men was similar to that in Caucasian men.
Public Health Significance: The biomarkers used for assessing CKD (serum creatinine and cystatin C) are influenced by body composition. Future CKD screening among blacks with high lean or muscle mass should include cystatin C assessment due to the influence of muscle mass on serum creatinine.
CKD is associated with bone loss. Proper management of bone minerals and DXA screenings are necessary in order to reduce bone loss among individuals with CKD.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Egwuogu, Heartleyhee6@pitt.eduHEE6
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBunker, BUNKERC
Committee MemberZmuda, Joseph M.zmudaj@edc.pitt.eduEPIDJMZ
Committee MemberMiljkovic, Ivamiljkovici@edc.pitt.eduIVM1
Committee MemberYouk, Adayouk@pitt.eduYOUK
Committee MemberAllen ,
Date: 27 September 2013
Date Type: Publication
Defense Date: 17 June 2013
Approval Date: 27 September 2013
Submission Date: 3 April 2013
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 183
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: EGFR African Americans Kidney Function Bone Loss Adiposity
Date Deposited: 27 Sep 2013 14:43
Last Modified: 15 Nov 2016 14:11


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