#3520 THE RELATIONSHIPS OF BONE TURNOVER MARKERS AND CEREBRAL WHITE MATTER ALTERATIONS IN PATIENTS UNDERGOING HEMODIALYSIS

Abstract

Abstract Background and Aims Patients with end-stage kidney disease (ESKD) have a higher prevalence rate of cognitive impairment than the general population. ESKD patients also present a worsening brain white matter damage than healthy subjects. Some studies showed a lower bone marrow density was associated with cognitive impairment, but limited studies investigated the relationship between bone turnover biomarkers and brain white matter damage in ESKD patients. Method Hemodialysis participants were enrolled in two hemodialysis units from August 2016 to January 2017. Participants' baseline characteristics, bone-turnover proteins, and Fazekas scale of brain magnetic resonance imaging (MRI) white matter lesions were recorded. Fazekas scale of periventricular lesions was defined as cerebral white matter hyperintensities in MRI from grade 0 to grade 3. Multivariable ordinal regression and logistic regression models were analyzed to identify the independent association between bone turnover proteins and the Fazekas scale of periventricular lesions. Results In 59 hemodialysis patients, a higher Fazeaks scale of periventricular lesions was found in elderly patients and correlated to a lower Mini-Mental State Examination (MMSE). Among 8 bone turnover proteins, the serum level of sclerostin (SOST) showed a dose-response effect (P value for trend = 0.004), corresponding to a higher level of SOST correlated with a lower grade on the Fazekas scale. After full adjustment with potential confounders, a negative association between SOST and Fazekas scale of periventricular lesions remained in the ordinal regression model (Odds ratio [OR] 0.886; 95% confidence interval [CI] 0.828-0.947, P value <0.001) and in the logistic regression model (OR 0.828; 95% 0.712-0.963, P value = 0.014). Conclusion The circulating SOST level was negatively associated with brain white matter damage. Our study result provided a potential link between bone turnover markers and brain damage.