Analysis of bone metabolism balance in chronic renal failure patients with 25-hydroxy vitamin D deficiency

doi:10.3969/j.issn.1673-8640.2015.02.011

Abstract

Abstract: Objective

To investigate the characteristics and relationship of bone metabolism in chronic renal failure patients with 25-hydroxy vitamin D deficiency.

Methods

A total of 80 chronic renal failure patients with 25-hydroxy vitamin D≤37.5 nmol/L were enrolled as study group, and 52 healthy subjects with 25- hydroxy vitamin D>75.0 nmol/L were as enrolled as control group. Their peripheral blood osteocalcin, total procollagen type Ⅰ amino terminal peptide (tP1NP), C-end peptide beta isomerization (β-CTx), parathyroid hormone (PTH), bone alkaline phosphatase (BAP), calcium, magnesium, phosphorus and ferrum were determined. The results were analyzed statistically.

Results

Compared to control group, tP1NP, osteocalcin, β -CTx, PTH and phosphorus in study group were higher than those in control group (P<0.01). The other parameters had no statistical significance (P>0.05). 25-hydroxy vitamin D levels and calcium were positively correlated [correlation coefficient (r)=0.33, P<0.05].

Conclusions

The characteristics of bone metabolism in chronic renal failure patients with 25-hydroxy vitamin D deficiency are enhancing the activity of osteoclasts and bone resorption significantly. It is more important to detect bone turnover rate than calcium in patients with chronic renal failure.

Key words: Bone metabolism, 25-hydroxy vitamin D, Chronic renal failure

CLC Number:

R446.1

WANG Ying, SHEN Jianxiong, XU Min, XUE Zhizhong. Analysis of bone metabolism balance in chronic renal failure patients with 25-hydroxy vitamin D deficiency[J]. Laboratory Medicine, 2015, 30(2): 149-151.

Figures/Tables 1

References 14

[1]	BANSAL B,BANSAL S,MITHAL A,et al.Vitamin D deficiency in hemodialysis patients[J]. Indian J Endocrinol Metab,2012,16(2):270-273.
[2]	National Kidney Foundation.K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease[J]. Am J Kidney Dis,2003,42(4 Suppl 3):S1-S201.
[3]	中华中医药学会肾病分会. 慢性肾衰竭的诊断、辩证分型及疗效评定(试行方案)[J]. 上海中医药杂志,2006,40(8):8-9.
[4]	QUERFELD U, MAK RH.Vitamin D deficiency and toxicity in chronic kidney disease: in search of the therapeutic window[J].Pediatr Nephrol,2010,25(12):2413-2430.
[5]	WANG AY,LAM CW, SANDERSON JE, et al.Serum 25-hydroxyvitamin D status and cardiovascular outcomes in chronic peritoneal dialysis patients: a 3-y prospective cohort study[J]. Am J Clin Nutr,2008,87(6):1631-1638.
[6]	张春华,申珅,王世相.维持性血液透析患者25-羟维生素D水平及其影响因素[J].中华医学杂志,2012,92(24):1690-1693.
[7]	SINGER RF.Vitamin D in dialysis: defining deficiency and rationale for supplementation[J]. Semin Dial,2013, 26(1):40-46.
[8]	BRANDI L.1alpha(OH)D3 one-alpha-hydroxy-cholecalciferol-an active vitamin D analog. Clinical studies on prophylaxis and treatment of secondary hyperparathyroidism in uremic patients on chronic dialysis[J]. Dan Med Bull,2008,55(4):186-210.
[9]	张军芳,蒋飞霞,徐裔婷. 骨代谢生化标志物与骨质疏松研究进展[J]. 中国热带医学,2009,9(3):569-570.
[10]	JAMALI Z, ARABABADI MK, ASADIKARAM G.Serum levels of IL-6, IL-10, IL-12, IL-17 and IFN-γ and their association with markers of bone metabolism in vitamin D-deficient female students[J]. Inflammation,2013,36(1):164-168.
[11]	童明宏,肖国平,丁慧.骨质疏松症与骨转换标志物的相关性研究[J].检验医学,2013,28(2):111-113.
[12]	PÉREZ-GARCÍA R,ALBATATE M,DE SEQUERA P,et al. On-line haemodiafiltration improves response to calcifediol treatment[J].Nefrologia,2012,32(4):459-466.
[13]	JEAN G,CHARRA B,CHAZOT C.Vitamin D deficiency and associated factors in hemodialysis patients[J]. J Ren Nutr,2008,18(5):395-399.
[14]	PECOVNIK-BALON B,JAKOPIN E,BEVC S,et al.Vitamin D as a novel nontraditional risk factor for mortality in hemodialysis patients[J]. Ther Apher Dial,2009,13(4):268-272.

组别	例数	25-羟维生素D(nmol/L)	tP1NP(ng/mL)	骨钙素(ng/mL)	β-CTx(pg/mL)	PTH(pg/mL)
慢性肾衰组	80	13.65±3.82^*	187.41±85.46^*	79.03±33.23^*	960.43±184.73^*	75.39±23.26^*
正常对照组	52	87.08±10.78	81.89±23.14	16.41±5.84	219.37±68.62	25.17±9.72
组别	例数	钙(mmol/L)	磷(mmol/L)	镁(mmol/L)	铁(μmol/L)	BAP(μg/L)
慢性肾衰组	80	2.25±0.48	1.68±0.56^*	1.15±0.26	13.01±8.52	16.22±6.76
正常对照组	52	1.19±0.12	1.19±0.12	1.08±0.07	16.36±5.05	17.90±7.64

组别	例数	25-羟维生素D(nmol/L)	tP1NP(ng/mL)	骨钙素(ng/mL)	β-CTx(pg/mL)	PTH(pg/mL)
慢性肾衰组	80	13.65±3.82^*	187.41±85.46^*	79.03±33.23^*	960.43±184.73^*	75.39±23.26^*
正常对照组	52	87.08±10.78	81.89±23.14	16.41±5.84	219.37±68.62	25.17±9.72
组别	例数	钙(mmol/L)	磷(mmol/L)	镁(mmol/L)	铁(μmol/L)	BAP(μg/L)
慢性肾衰组	80	2.25±0.48	1.68±0.56^*	1.15±0.26	13.01±8.52	16.22±6.76
正常对照组	52	1.19±0.12	1.19±0.12	1.08±0.07	16.36±5.05	17.90±7.64