Investigating the association between creatinine-adjusted urinary catecholamines and site-specific bone mineral density in older adults.

OBJECTIVES

Osteoporosis is common among older adults, but the relationship between neuroendocrine factors - particularly catecholamines - and bone mineral density (BMD) is not well understood. This study examined associations between catecholamine levels and BMD in older adults.

METHODS

Data from the 2017-2022 biomarkers wave of the Midlife in the United States (MIDUS 3) study were analyzed. Multiple linear regressions assessed associations between creatinine-adjusted urinary norepinephrine and epinephrine levels and BMD at the lumbar spine (L1-L4), right and left total femur, and one-third radius. Models adjusted for age, sex, body mass index (BMI), smoking history, diet, medications (thiazide diuretics, phosphate binders, beta blockers, and vitamin D analogues), and serum creatinine.

RESULTS

Among 324 participants (41 % male; mean age 64.3±9.3 years), higher epinephrine levels were significantly associated with lower lumbar spine BMD (Beta=-0.122; 95 % CI: [-0.242 to -0.003], p=0.045), while norepinephrine showed no association (p=0.865). No significant relationships were observed at femoral or radial sites, though norepinephrine was marginally linked to lower one-third radius BMD (Beta=-0.087; 95 % CI: [-0.176 to 0.002], p=0.055). Male sex and higher BMI predicted greater BMD (p<0.05), whereas older age was linked to lower femoral and radial BMD (p<0.05).

CONCLUSIONS

Elevated epinephrine levels are associated with reduced lumbar spine BMD in older adults, and elevated norepinephrine levels are associated with reduced distal radius BMD, suggesting catecholamines may influence bone metabolism in a site-specific manner relevant to osteoporosis pathophysiology.