摘要
Abstract
Objective To investigate the correlations of osteoporosis and cardiovascular calcification with markers of bone metabolism in patients with chronic kidney disease(CKD).Methods A total of 412 patients with CKD were included and divided into a CKD stage 3 group(46 cases),a CKD stage 4 group(54 cases),or a CKD stage 5 group(312 cases)according to their CKD stage,and 60 healthy individuals underwent physical examination were selected as the control group.The biochemical indexes,bone metabolism indexes,conditions of osteoporosis and cardiovascular calcification,and serum inflammatory factors levels were compared among groups.Spearman's rank correlation was used to analyze the correlations of osteoporosis and cardiovascular calcification with markers of bone metabolism in patients with different CKD stages.Results The estimated glomerular filtration rate(eGFR)levels of the CKD stage 3,4,and 5 groups were lower than that of the control group,and the eGFR level of CKD patients decreased with CKD stage increasing(all P＜0.05).The serum levels of phosphorus,intact parathyroid hormone(iPTH),bone alkaline phosphatase(BALP),type 1 procollagen N-terminal peptide(P1NP),and β-crosslinked C-terminal telopeptide of type 1 collagen(β-CTX)in the CKD stage 3,4,and 5 groups were higher than those in the control group;with CKD stage increasing,the serum levels of phosphorus,iPTH,BALP,P1NP,and β-CTX in CKD patients increased(all P＜0.05).The incidence of osteoporosis in the CKD stage 5 group was higher than that in the control group,CKD stage 3 group,and CKD stage 4 group;the incidences of cardiovascular calcification in the CKD stage 3,4,and 5 groups were higher than that in the control group;the incidence of heart valve calcification in the CKD stage 5 group was higher than that in the control group,the CKD stage 3 group,and the CKD stage 4 group(all P＜0.05).The results of Spearman's rank correlation analysis showed that the incidences of osteoporosis,cardiovascular calcification,and heart valve calcification were negatively correlated with eGFR and serum calcium level,and positively correlated with serum phosphorus,iPTH,BALP,P1NP,and β-CTX levels in CKD patients(all P＜0.05).With CKD stage increasing,the serum levels of interleukin-6,tumor necrosis factor-α,and C-reactive protein increased in CKD patients(all P＜0.05).Conclusion Osteoporosis and cardiovascular calcification are closely correlated to eGFR and the level of bone metabolism indexes in CKD patients.关键词
慢性肾脏病/骨质疏松/心血管钙化/骨代谢标志物/相关性分析Key words
Chronic kidney disease/Osteoporosis/Cardiovascular calcification/Marker of bone metabolism/Correlation analysis分类
医药卫生
