Interrelations among vascular calcification, bone density, osteoprotegerin and soluble receptor activator of nuclear factor kB ligand in hemodialysis patients / 中华肾脏病杂志

ABSTRACT

Objective To examine the interrelations among vascular calcification, bone denaity,osteoprotegerin (OPG) and soluble receptor activator of NF-kB ligand (sRANKL) in maintenance hemodialysis (MHD) patients. Methods The levels of serum OPG and sRANKL from 39 MHD patients were measured by ELISA. The vascular calcification was detected by plain radiographs. Bone mineral density (BMD) was measured with dual-energy X-ray absorptionmeter.Interrelations among above parameters were examined statistically. Results (1) Among 39 MHD patients, 25 cases were identified as vascular calcification by radiographic film. The proportion of patients with mild vascular calcification was 41.0% (16 cases), moderate and severe vascular calcification was 23.1% (9 cases). Compared to patients with mild vascular calcification,serum OPG level [(342.50±171.53) ng/L vs (206.21±137.88) ng/L,t=-2.253, P=0.0251 and OPG/sRANKL ratio (454.65±455.63 vs 135.31±136.81, t=59, P=0.035)were significantly higher in patients with moderate and severe vascular calcification,while serum sRANKL level [(0.10±0.08) pmol/L vs (0.12±0.08) pmol/L, t=0.534, P>0.05] was not significantly different. Multiple linear regression analysis showed that OPG/sRANKL ratio was independent factor of vascular calcification score. (2)Compared to patients with normal bone volume, the patients with abnormal bone volume had higher serum OPG level [(249.05±137.66) ng/L vs (226.67±170.12) ng/L], lowerserum sRANKL level [(0.11±0.08) pmol/L vs (0.12±0.02) pmol/L], and higher OPG/sRANKL ratio(202.31±219.24 vs 148.08±210.10), but these parameters were not significantly different betweenthese two groups. Multiple linear regression analysis showed that OPG/sRANKL ratio was anindependent factor of T score of lumbar vertebra. (3)Muhiple linear regression analysis revealed that vascular calcification score was an independent factor of T score of lumbar vertebra and hip.Conclusions Vascular calcification score is an independent factor of BMD of lumbar vertebra and hip in MHD patients. Serum OPG/sRANKL ratio may play an important role in the association between vascular calcification and BMD in MHD patients.