| Objective: To study the association of serum indole sulfate with mineral metabolism and bone mineral density in hemodialysis patients.Methods: 78 patients who had maintained hemodialysis for more than 6 months in the Department of Nephrology,Qingdao Municipal Hospital Affiliated to Qingdao University,and 20 volunteers who had physical examination in the physical examination center were selected.The clinical data were collected and the level of serum IS was detected by enzymelinked immunosorbent assay(ELISA).The bone mineral density(BMD)of lumbar vertebrae was measured by DEXA in HD patients.The calcification degree of abdominal aorta was evaluated by lateral abdominal plain film,and the abdominal aorta calcification score(AACs)was calculated.According to the serum IS,the patients was divided into the low IS group and the high IS group.According to the T value of bone mineral density(BMD),the patients were divided into normal group(t ≥-1.0),osteopenia group(-2.5 < T <-1.0),osteoporosis group(t ≤-2.5).The clinical biochemical data of each group were compared by Pearson or Spearman correlation analysis.The independent risk factors of IS in HD patients were analyzed by logistic regression analysis.The sensitivity and specificity of IS in predicting osteoporosis were evaluated by Receiver Operating Characteristic(ROC)Curve.Results: 1.The mean value of IS was 469.07 ± 115.45ng/ml in healthy controls and 7723.96 ± 1489.75ng/ml in PD patients,the difference was significant(P < 0.05).2.Among the HD patients in the experimental group,the age,dialysis age,serum creatinine,PTH,serum phosphorus,and AACs in the high IS group were higher than those in the low IS group,and the T value was lower in the high IS group.The age of the osteopenia group was higher than that of the normal group;The age,dialysis age,serum phosphorus,serum IS,and AACs of the osteoporosis group were higher than those of the normal group,but serum albumin was lower than the normal group;The age,female ratio,dialysis age,serum phosphorus,serum IS and AACs of osteoporosis group were higher than those of the osteopenia group。These differences were statistically significant(P <0.05).3.Linear correlation analysis showed:The serum IS was positively correlated with age,dialysis age,creatinine,urea nitrogen,PTH,phosphorus and AACs,and negatively correlated with T value.T value was negatively correlated with age,dialysis age,PTH,serum phosphorus,alkaline phosphatase,serum IS and AACs,and positively correlated with serum albumin level.Logistic regression analysis showed that IS was negatively correlated with T value(β =-5.130,P < 0.05),positively correlated with AACs(β = 0.825,P < 0.01),and weakly positively correlated with creatinine(β = 0.011,P = 0.051).4.ROC analysis: The area under the curve(AUC)of IS predicting osteoporosis is 0.893(P<0.01).When 8085.16ng/ml as the cut-off point of IS,the sensitivity and specificity of IS predicting osteoporosis are 88.0% and 73.6%.Conclusion: The serum indole sulfate was negatively correlated with T-value of lumbar BMD in HD patients,and the serum IS had a certain predictive value for lumbar vertebra osteoporosis,suggesting that IS may participate in the development of chronic kidney disease-mineral and bone disorder in HD patients.There was an independent positive correlation between serum IS and abdominal aortic calcification score in HD patients,suggesting that IS may be involved in the occurrence of abdominal aortic calcification and the development of CKD-MBD.There was significant correlation between serum IS and serum creatinine,urea nitrogen,PTH,blood phosphorus.The higher the serum indole sulfate level was,the higher serum creatinine,urea nitrogen,PTH,blood phosphorus levels were. |
