The Expression Characteristics And Correlation Analysis Of Bone Mineral Density And Bone Turnover Biomarkers In Patients With Chronic Kidney Diseases

Purpose: The purpose of our study is to analyze the expression,variation tendency and correlation of bone mineral density(BMD)and bone turnover biomarkers(BTMs),to explore the predictive value of BTMs for osteoporosis.Methods: We collected patients with CKD(including calciphylaxis patients)admitted in Zhongda hospital Southeast University from 2018.01.01 to 2021.09.30 retrospectively.The patients were divided into the following four groups: CKD1-2 stage group,CKD3-5ND stage group,CKD5 D group(without calciphylaxis)and calciphylaxis group.We analyzed the differences among these groups and explored the correlation between the BMD and BTMs.We use Logistic regression analysis to find out the risk factors for osteoporosis.Finally,we drew the ROC curves to explore if the BTMs can predict the osteoporosis.Results: A total of 326 CKD patients was included.With the progression of the CKD,BMD decreased and BTMs became disordered significantly,calciphylaxis patients were more seriously than general dialysis patients.Logistic regression analysis showed that male(OR=0.558,95%CI 0.348～0.895,P=0.016)and BMI(OR=0.890,95%CI 0.829～0.953,P=0.001)were the protect factors of left total hip bone loss,high log PTH(OR=5.140,95%CI 1.974～13.396,P=0.001)was an independent risk factor of left total hip bone loss.Male(OR=0.554,95%CI 0.349～0.879,P=0.012)and BMI(OR=0.911,95%CI 0.313～0.975,P=0.007)were the protect factors of lumbar bone loss,high ALP(OR=1.008,95%CI1.003～1.013,P=0.003)was an independent risk factor for lumbar bone loss.In the ROC curve of left total hip,the area under the curve(AUC)of PTH was 0.776,and was the highest one.In the ROC curve of lumbar spine,the area under the curve(AUC)of ALP was0.708,and was the highest one.The combination of PTH,ALP and TPINP can predict osteoporosis more accurately.Conclusions: When the GFR decreased,CKD patients without calciphylaxis BMD and BTMs became abnormal gradually.The mineral and bone disorder in Calciphylaxis patients were more serious than other patients.PTH and ALP were risk factors and predictors for osteoporosis in CKD patients.Early detection of BMD and BTMs can help us to diagnose and manage the CKD-MBD in the early stage.