Influence of the hepatocellular damage on the clinical usefulness of biochemical markers of bone metabolism and parathormon in haemodialysed patients.
BACKGROUND
The present study was undertaken to determine if hepatitis C virus (HCV) and cytomegalovirus (CMV) infections, as well as biochemical indices of liver damage, can significantly influence the relationships occurring between markers of bone formation, resorption and PTH in hemodialysis patients.


METHODS
76 HD patients were tested for anti-HCV and anti-CMV antibodies. Serum intact PTH osteocalcin, total and bone isoenzyme of alkaline phosphatase, and plasma tartrate-resistant acid phosphatase were determined as bone metabolism indices. Serum alanine aminotransferase (ALT) and gamma-glutamyl transferase (gamma-GT) were measured as markers of hepatocyte function. The patients were divided into subgroups according to serological and enzymatic status.


RESULTS
37 patients were anti-HCV positive, 61 were anti-CMV positive, and 35 were both anti-HCV and anti-CMV positive. 13 patients were free of viruses. Elevated ALT and gamma-GT activity was found in 26 and 15 patients respectively. Indices of bone formation, resorption and PTH values showed no significance differences in the respective subgroups. Markers of bone formation significantly correlated with one another, as well as markers of bone resorption and intact PTH in all patients. In the subgroup of patients with increased gamma-GT activity, significant differences were found in the slopes of the regression lines occurring in most of the estimated correlations in comparison with all other subgroups.


CONCLUSIONS
In renal osteodystrophy, hepatocellular damage indicated by an increase of gamma-GT influences the relationship between the biochemical markers of bone metabolism and parathormon levels, but the presence of anti-HCV and anti-CMV antibodies does not.
Jaroszyński
Andrzej J
AJ
Department of Nephrology, Medical University of Lublin, Poland.
Ksiazek
Andrzej
A
Załuska
Wojciech
W
D000328:Adult; D000368:Aged; D001862:Bone Resorption / Q000821:virology; D001842:Bone and Bones / Q000378:metabolism*; D003587:Cytomegalovirus / Q000378:metabolism; D003586:Cytomegalovirus Infections / Q000378:metabolism; D005260:Female; D016174:Hepacivirus / Q000378:metabolism; D006526:Hepatitis C / Q000378:metabolism; D006801:Humans; D008099:Liver / Q000293:injuries* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects*
D010281:Parathyroid Hormone