[Hormonal activity of the hypophysial-gonadal axis versus the mineral bone density and specific markers of bone turnover in haemodialysis population].
Among the numerous complications associated with chronic renal disease both bone and hormonal disturbances have long been recognized. The aim of this study was to assess the relations between bone mineral density, gonadal status and specific markers of bone turnover in haemodialysis (HD) population.


METHODS
We performed a cross-sectional study involving 40 HD patients: 27 men (mean age 54 +/- 14, 2 years) and 13 women (mean age 58.9 +/- 9.8 years), mean HD time 68 +/- 43 months. Serum levels of testosterone, estradiol, LH, FSH, osteocalcin (OC), beta-CrossLaps, iPTH and alkaline phosphatase (ALP) were measured. Bone mineral density (BMD) was estimated in the lumbar spine and in the femoral neck using dual energy absorptiometry (DXA).


RESULTS
67.5% of HD patients showed a low BMD. Diagnostic criteria of osteoporosis were fulfilled by 32.5% of subjects, they were found more frequently in women (38.5%) than in men (29.6%). Osteopenia was observed in 35% of patients, more frequent in women (46.2%) than in men (29.6%). Mean serum levels of FSH and LH were above the normal range and they were higher in women that in men. The serum levels of estradiol in women were below normal range in 11 from 13 subjects (84.6%). The mean serum testosterone concentrations in HD men were in normal range. We also observed a positive correlation between serum beta-CrossLaps concentrations and PTH (in men p < 0.001, r = 0.66; in women p < 0.006, r = 0.71) and between serum OC levels and PTH (in men p < 0.02, r = 0.44; in women p < 0.01, r = 0.65), respectively. CONCLUSIONS; The frequency of low bone mineral density in haemodialysis patients is high, more common in women. Hypergonadotropic hypogonadism that occurs in dialysis patients may be one of the main risk factors of bone disturbances in these patients. The levels of bone turnover markers are mainly determined by the severity of hyperparathyroidism.
Kurnatowska
Ilona
I
Uniwersytet Medyczny w Lódzi, Klinika Nefrologii, Hipertensjologii i Transplantologii Nerek. kuril@wp.pl
Zygmunt
Arkadiusz
A
Fijałkowska-Morawska
Jolanta
J
Białkowska
Jolanta
J
Jabłkowski
Maciej
M
Nowicki
Michał
M
Lewiński
Andrzej
A
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D015897:Comorbidity; D005260:Female; D006801:Humans; D007006:Hypogonadism / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000453:epidemiology*; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution
D015415:Biomarkers