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Bone mineral density and bone metabolism in hemodialysis patients. Correlation with PTH, 25OHD3 and leptin

A Polymeris1, K Doumouchtsis, E Grapsa

  • 1Second Division of Endocrinology, Alexandra Hospital, Athens, Greece. antonispolymeris@yahoo.gr

Nefrologia : Publicacion Oficial De La Sociedad Espanola Nefrologia
|December 2, 2011
PubMed

Insights

In hemodialysis patients, high parathyroid hormone (PTH) levels correlate with bone metabolism markers. However, elevated leptin levels showed no association with bone metabolism or bone density in this study.

Area of Science:

  • Nephrology
  • Endocrinology
  • Bone Metabolism

Background:

  • Bone metabolism disorders are common in hemodialysis (HD) patients, with parathyroid hormone (PTH) playing a central role.
  • Leptin levels are often elevated in renal failure, but their impact on bone metabolism remains unclear.
  • This study investigates bone mineral density (BMD) and bone metabolism in relation to PTH, 25-hydroxyvitamin D3 (25OHD3), and leptin in HD patients.

Purpose of the Study:

  • To examine the relationship between serum PTH, 25OHD3, and leptin levels and their association with bone metabolism and BMD in hemodialysis patients.
  • To determine if leptin levels correlate with bone turnover markers or bone density in this patient population.

Main Methods:

  • Measured bone alkaline phosphatase (bSAP), N-telopeptide of type 1 collagen (NTx), PTH, 25OHD3, and leptin in 37 HD patients.
  • Evaluated Body Mass Index (BMI) and BMD at the lumbar spine (LS) and femoral neck (FN) using dual-energy X-ray absorptiometry (DXA).
  • Employed simple regression analysis for statistical evaluation.

Main Results:

  • Osteopenia and osteoporosis were prevalent, affecting 32.1%-50% and 14.3%-21.4% of patients, respectively.
  • Bone markers, PTH, phosphorus, and leptin levels were elevated; 25OHD3 levels were low.
  • PTH positively correlated with bone markers and Z scores at LS and FN, while leptin showed no significant correlation with bone metabolism or BMD (except with BMI).

Conclusions:

  • Hemodialysis patients exhibit increased bone metabolism markers linked to high serum PTH levels.
  • Elevated serum leptin in these patients is not associated with altered bone metabolism or density.
  • The duration of hemodialysis did not significantly impact bone density in the studied cohort.
Abstract

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