Serum osteocalcin concentration as a biomarker of osteoporosis in Egyptian patients with chronic renal failure on regular hemodialysis

Document Type : Original Article

Authors

1 Department of Internal Medicine, Faculty of Medicine, Beni-Suef University

2 Department of Clinical and Chemical Pathology, Faculty of Medicine, Beni-Suef University

Abstract

Background: To prevent and treat mineral bone damage in those with long-term kidney failure [CKD-MBD], early detection and intervention are crucial. Osteocytes, odontoblasts, and osteoblasts create a protein called osteocalcin [OC], which is dependent on vitamins K and D. It is present in serum and deposited in the extracellular bone matrix. Serum osteoblast activity and bone formation rate are thought to be indicated by serum OC hydrolyzed in the kidney and liver. It might impact mineralization, bone turnover, and osteoblast function control. Aim and Objectives: to assess the serum osteocalcin levels in Egyptian patients receiving regular hemodialysis as a biomarker of osteoporosis due to chronic renal failure.  Patients and methods: The Beni-Suef University Hospital's internal medicine department and hemodialysis unit were the sites of this case-control research. In addition to 45 healthy controls, 45 CRF patients were included in this research.  Results: When comparing Dexa results, kidney function tests, osteocalcin levels, correlations between osteocalcin levels, and other laboratory investigations, the study found a statistically significant difference in the sensitivity and specificity of osteocalcin levels in the diagnosis of osteoporosis CRF cases from controls. Specifically, there was a significantly lower GFR [mean 7.09] and a significantly higher level of osteocalcin [mean 62.1] with a p-value <0.05 among cases compared to controls [mean 29.6]. These findings concluded that osteocalcin levels were elevated in CRF patients with osteoporosis. Conclusion: Osteocalcin may be a useful biomarker for osteoporosis early detection ing patients receiving frequent hemodialysis and chronic renal failure. According to the study, serum osteocalcin measurement may be utilized as a potential supplementary biomarker in conjunction with a Dexa scan for the early identification of CKD-MBD and the tracking of osteoporosis progression in clinical settings.

Keywords

Main Subjects

References

  1. Tsugawa N, Shiraki M, Suhara Y, Kamao M, Ozaki R, Tanaka K, Okano T. Low plasma phylloquinone concentration is associated with high incidence of vertebral fracture in Japanese women. Journal of bone and mineral metabolism. 2008 Jan;26:79-85.
  2. Muñoz-Torres M, De la Higuera M, Fernández-García D, Alonso G, Reyes R. Densitometría ósea: indicaciones e interpretación. Endocrinología y Nutrición. 2005 May 1;52(5):224-7.
  3. Kidney Disease: Improving Global Outcomes (KDIGO) CKD‐MBD Update Work Group. Kidney International Supplements. 2017;7(1):1-59.
  4. Moe S, Drüeke T, Cunningham J, Goodman W, Martin K, Olgaard K, Ott S, Sprague S, Lameire N, Eknoyan G. Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney international. 2006 Jun 1;69(11):1945-53.
  5. Blake GM, Fogelman I. The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgraduate medical journal. 2007 Aug;83(982):509-17.
  6. Eastell R, Hannon RA. Biomarkers of bone health and osteoporosis risk*: Symposium on ‘Diet and bone health’. Proceedings of the Nutrition Society. 2008 May;67(2):157-62.
  7. Greenblatt MB, Tsai JN, Wein MN. Bone turnover markers in the diagnosis and monitoring of metabolic bone disease. Clinical chemistry. 2017 Feb 1;63(2):464-74.
  8. Delmas PD, Eastell R, Garnero P, Seibel MJ, Stepan J, Committee of Scientific Advisors of the International Osteoporosis Foundation. The use of biochemical markers of bone turnover in osteoporosis. Osteoporosis international. 2000 Dec 1;11(6):S2.
  9. Novak M, Winkelman JW, Unruh M. Restless legs syndrome in patients with chronic kidney disease. InSeminars in nephrology 2015 Jul 1 (Vol. 35, No. 4, pp. 347-358). WB Saunders.
  10. Fujii H, Joki N. Mineral metabolism and cardiovascular disease in CKD. Clinical and experimental nephrology. 2017 Mar;21:53-63.
  11. Daya NR, Voskertchian A, Schneider AL, Ballew S, DeMarco MM, Coresh J, Appel LJ, Selvin E, Grams ME. Kidney function and fracture risk: the Atherosclerosis Risk in Communities (ARIC) study. American Journal of Kidney Diseases. 2016 Feb 1;67(2):218-26.
  12. Lima GA, de Paula Paranhos-Neto F, Silva LC, de Mendonça LM, Delgado AG, Leite Jr M, Gomes CP, Farias ML. Bone density is directly associated with glomerular filtration and metabolic acidosis but do not predict fragility fractures in men with moderate chronic kidney disease. Journal of Clinical Densitometry. 2016 Apr 1;19(2):146-53.
  13. Cosman F, Crittenden DB, Adachi JD, Binkley N, Czerwinski E, Ferrari S, Hofbauer LC, Lau E, Lewiecki EM, Miyauchi A, Zerbini CA. Romosozumab treatment in postmenopausal women with osteoporosis. New England Journal of Medicine. 2016 Oct 20;375(16):1532-43.
  14. Lee NK, Sowa H, Hinoi E, Ferron M, Ahn JD, Confavreux C, Dacquin R, Mee PJ, McKee MD, Jung DY, Zhang Z. Endocrine regulation of energy metabolism by the skeleton. Cell. 2007 Aug 10;130(3):456-69.
  15. Singh S, Kumar D, Lal AK. Serum osteocalcin as a diagnostic biomarker for primary osteoporosis in women. Journal of clinical and diagnostic research: JCDR. 2015 Aug;9(8):RC04.
  16. Chi PJ, Shih-Yuan H, Hsiao FT, Liou HH, Tsai JP. Serum osteocalcin concentration as an independent biomarker of osteoporosis in patients with chronic kidney disease. Clinical Nephrology. 2022 Jul 1;98(1):1.
  17. SOHIER M, OSMAN DT, HAMED EK, HOSSAM ED. Assessment of Movement Control Impairment in Mechanical Low Back Pain Post Menopause. The Medical Journal of Cairo University. 2021 Dec 1;89(December):2801-8.
  18. Alpdemir M, Fidanci V, Alpdemir MF, Alper AZ, Saydam G, Duranay M, Yücel D. Serum undercarboxylated osteocalcin levels are related to bone disease in hemodialysis and peritoneal dialysis patients. The European Research Journal. 2021.
  19. Kuźniewski M, Fedak D, Dumnicka P, Stępień E, Kuśnierz-Cabala B, Cwynar M, Sułowicz W. Osteoprotegerin and osteoprotegerin/TRAIL ratio are associated with cardiovascular dysfunction and mortality among patients with renal failure. Advances in medical sciences. 2016 Sep 1;61(2):269-75.
  20. Csiky B, Sági B, Peti A, Lakatos O, Prémusz V, Sulyok E. The impact of osteocalcin, osteoprotegerin and osteopontin on arterial stiffness in chronic renal failure patients on hemodialysis. Kidney and Blood Pressure Research. 2018 Dec 15;42(6):1312-21.
  21. Xie D, Zhao L, Wu L, Ji Q. The levels of bone turnover markers and parathyroid hormone and their relationship in chronic kidney disease. Clinica Chimica Acta. 2023 Aug 1;548:117518.
  22. Lv J, Xie W, Wang S, Zhu Y, Wang Y, Zhang P, Chen J. Associated factors of osteoporosis and vascular calcification in patients awaiting kidney transplantation. International Urology and Nephrology. 2023 Dec;55(12):3217-24.

 

 

 

Files

Share

How to cite

Statistics