To Investigate The Correlation Between Bone Metabolism Markers And Renal Osteodystrophy

Objective: To compare the characteristics of bone metabolism marker,such as osteocalcin(OC),N-terminal propeptide of type I procollagen(PINP)and type I collagen carboxyl terminal peptide β special sequence(β-CTX)in normal renal function group and renal failure group,and to analyze the correlation between osteocalcin,PINP、β-CTX and parathyroid hormone(i PTH),blood calcium(Ca)and blood phosphorus(P)in patients with chronic kidney disease.To explore the correlation between bone metabolism markers and renal osteodystrophy in order to detect renal osteodystrophy early.Methods: Collected from collecting 208 patients of bone metabolic markers as the research object,including 180 patients with chronic kidney disease and 28 patients with normal renal function.Collection of two groups of patients with gender,age,weight,height,body mass index(BMI),and other general clinical data,collecting Serum creatinine(Cr),glomerular filtration rate(e GFR),osteocalcin,PINP,β-CTX,blood calcium,phosphorus,parathyroid hormone by blood(i PTH)and so on biochemical indicators,as well as whether patients with dialysis,whether the use of bone disease related drugs.Compared the above data of normal renal function group and chronic kidney disease group,and the correlation between osteocalcin,PINP,β-CTX and i PTH,serum calcium and serum phosphorus in the patients with chronic kidney disease stage 3,stage 4 and stage 5 were analyzed respectively.Results: 1.There were significant differences in serum creatinine,EGFR,OC,β-CTX,PINP,serum calcium and serum phosphorus between normal renal function group and patients with chronic kidney disease(P <0.05),and the levels of osteocalcin,β-CTX,PINP and i PTH in CKD group were significantly higher than those in non-CKD group(P < 0.05).2.There were no significant differences in serum creatinine,glomerular filtration rate,osteocalcin,β-CTX,PINP,serum calcium and serum phosphorus among different genders in patients with chronic kidney disease(P >0.05).3.Correlation analysis of bone metabolism markers in CKD group:Spearman correlation coefficient rs of osteocalcin and IPTH in CKD4 group was 0.683(P < 0.05),and the Spearman correlation coefficient rs of osteocalcin and IPTH in CKD5 group was 0.353(P<0.001),Spearman correlation coefficient rs of β-CTX and IPTH in CKD5 group was 0.545,(P < 0.001),and Spearman correlation coefficient rs of PINP and IPTH in CKD5 group was 0.280,(P < 0.05).Spearman correlation coefficient rs of osteocalcin and serum phosphorus in CKD stage 5 group was 0.170(P <0.05).4.With the progression of CKD,osteocalcin,β-CTX,PINP,IPTH,serum calcium and serum phosphorus in CKD3 B stage showed an increasing trend.Conclusions: 1.Bone metabolic markers were significantly higher in the chronic kidney disease group than in the normal renal function group;2.There were no significant differences in serum creatinine,glomerular filtration rate,osteocalcin,β-CTX,PINP,serum calcium and serum phosphorus among different genders in patients with chronic kidney disease;3.There was a positive correlation between osteocalcin and IPTH in patients with stage 4 chronic kidney disease,and there was a positive correlation between bone metabolic markers(osteocalcin,β-CTX,PINP)and IPTH in patients with stage 5 chronic kidney disease,among which β-CTX had the highest correlation with IPTH,while osteocalcin was positively correlated with serum phosphorus.4.With the progression of disease,the changes of bone metabolism markers were earlier than those of serum calcium,serum phosphorus and i PTH in patients with chronic kidney disease.It is suggested that bone metabolism markers may be used in the early diagnosis of renal osteodystrophy and in the evaluation of the severity of renal osteodystrophy.