Abstract
IntroductionOsteoporosis is one of the important bone abnormalities in chronic kidney disease-mineral and bone disorder (CKD-MBD) and still lacks a sensitive biomarker to diagnose. Fibroblast growth factor 21 (FGF21) can stimulate bone loss in patients with diabetes and increase in CKD patients. In this study, we investigated whether FGF21 could serve as a biomarker to predict osteoporosis in a haemodialysis cohort.MethodsWe recorded demographic information, biochemical data, and serum FGF21 and FGF23 levels and measured the CT attenuation values of 339 haemodialysis patients from two large medical centres. We assessed the correlation of CT attenuation values with serum FGF21 and FGF23 levels and tested whether they were independent factors for osteoporosis. ROC curves were constructed to compare the prognostic value of FGF21 and FGF23 for osteoporosis.ResultsBased on the CT attenuation value, serum FGF21 levels were higher in our osteoporosis group (median 640.86 pg/ml vs. 245.46 pg/ml, P ˂ 0.01). Meanwhile, FGF21 (r = -0.136, P < 0.05) and FGF23 (r = -0.151, P < 0.05) were both negatively associated with osteoporosis. Moreover, FGF21 (β = -0.067, P < 0.05) was an independent factor for osteoporosis. Furthermore, FGF21 combined with age yielded a marked specificity (90.5 %) and sensitivity (61.8 %) in predicting osteoporosis of haemodialysis patients with less residual renal function.ConclusionsFGF21 has a positive relationship with the incidence of osteoporosis in patients on haemodialysis. FGF21 combined with age is a good predictive biomarker for osteoporosis in patients on haemodialysis, especially those with less residual renal function.
Highlights
Osteoporosis is one of the important bone abnormalities in chronic kidney disease-mineral and bone disorder (CKD-MBD) and still lacks a sensitive biomarker to diagnose
Patients on HD had a mean age of 66.45 ± 13.28 years and a median serum Fibroblast growth factor 21 (FGF21) level of 640.86 pg/ml
Patients had a mean age of 52.86 ± 14.77 years and a median serum FGF21 level of 245.46 pg/ ml
Summary
Osteoporosis is one of the important bone abnormalities in chronic kidney disease-mineral and bone disorder (CKD-MBD) and still lacks a sensitive biomarker to diagnose. CKD-MBD is composed of three main aspects: renal bone disease, vascular or other soft-tissue calcification, and biochemical abnormalities such as calcium, phosphate, parathyroid hormone (PTH), and fibroblast growth factor 23 (FGF23) [4]. Individuals with early stages of CKD may have a higher prevalence of osteoporosis and fracture risk compared to non-CKD and 20 % mortality from hip fractures within the first year [6,7,8] Many factors, such as secondary hyperparathyroidism, vitamin D deficiency, increased FGF23, and metabolic acidosis, are involved in the pathophysiology of subsequent osteoporosis in patients with CKD [9]. Some scholars proposed that FGF23 could predict bone loss in patients with ESRD through its strong correlation with bone mineral density (BMD) in lumbar spine sites and femoral neck sites [14, 15]. The association of FGF21 with bone loss in CKD has rarely been explored in previous studies
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
