Abstract
Background and Objectives: Osteoprotegerin (OPG), a potent osteoclast activation inhibitor, decreases bone resorption and plays a role in mediating bone mineral density (BMD). Our aim was to evaluate the relationship between BMD and serum OPG in maintenance hemodialysis (MHD) patients. Materials and Methods: Fasting blood samples were obtained from 75 MHD patients. BMD was measured by dual-energy X-ray absorptiometry in lumbar vertebrae (L2–L4). The WHO classification criteria were applied to define osteopenia and osteoporosis. A commercial enzyme-linked immunosorbent assay was used to measure serum OPG values. Results: Among all MHD patients, seven (9.3%) and 20 patients (26.7%) were defined as osteoporosis and osteopenia, respectively. Female patients had lower lumbar BMD than males (p = 0.002). Older age (p = 0.023), increased serum OPG (p < 0.001) urea reduction rate (p = 0.021), Kt/V (p = 0.027), and decreased body mass index (p = 0.006) and triglycerides (p = 0.020) were significantly different between the normal, osteopenia, and osteoporosis groups. Lumbar spine BMD was positively correlated with body mass index (BMI) (p < 0.001) but negatively correlated with OPG (p < 0.001) and age (p = 0.003). After grouping patients into T scores < −1 and < −2.5, female sex and OPG (adjusted odds ratio [aOR] 1.022, 95% confidence interval [C.I.] 1.011–1.034, p < 0.001) were predictors of T scores < −1, whereas only OPG was predictive of T scores < −2.5 (aOR 1.015, 95% C.I. 1.005–1.026, p = 0.004) by multivariate stepwise logistic regression analysis. The areas under the curve for predicting T scores < −1 or < −2.5 were 0.920 (95% C.I. 0.834–0.970, p < 0.001) and 0.958 (95% C.I. 0.885–0.991, p < 0.001), respectively. Conclusions: Increased serum OPG negatively correlated with lumbar BMD and could be a potential biomarker predictive of osteoporosis in MHD patients.
Highlights
Chronic kidney disease (CKD) is a health burden affecting nearly 700 million people worldwide that has a higher risk of cardiovascular disease (CVD) [1]
CKD is a prominent risk factor of fractures related to dysregulated bone metabolism, which is known as CKD-related mineral bone disease, and the risk is higher than the risk in the general population [2,3,4]
Values of lumbar bone mineral density (BMD) and T scores were significantly lower for the female maintenance hemodialysis (MHD) patients than for the males (Figure 1)
Summary
Chronic kidney disease (CKD) is a health burden affecting nearly 700 million people worldwide that has a higher risk of cardiovascular disease (CVD) [1]. CKD is a prominent risk factor of fractures related to dysregulated bone metabolism, which is known as CKD-related mineral bone disease, and the risk is higher than the risk in the general population [2,3,4]. In maintenance hemodialysis (MHD) patients, abnormal low bone mass and density are common, and the examined bone mineral density (BMD) has shown that the prevalence of osteoporosis and osteopenia were 9.5–23% and 16.7–45%, respectively [5,6]. CKD patients with osteoporosis and osteopenia have a substantially increased risk of fractures leading to a huge public health burden worldwide [7]. Our aim was to evaluate the relationship between BMD and serum OPG in maintenance hemodialysis (MHD). Results: Among all MHD patients, seven (9.3%) and 20 patients (26.7%) were defined as osteoporosis and osteopenia, respectively
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