title: Significant inverse relationship between serum undercarboxylated osteocalcin and glycemic control in maintenance hemodialysis patients.
abstract: CONCLUSIONS
  Increased levels of serum undercarboxylated osteocalcin, which were associated with bone metabolism markers, correlated inversely with indices of glucose metabolism (plasma glucose, hemoglobin A1C, and glycated albumin) in hemodialysis patients with abnormalities of bone metabolism.
  
  
  BACKGROUND
  Undercarboxylated osteocalcin (ucOC), a possible marker of bone metabolism and one of the osteoblast-specific secreted proteins, has recently been reported to be associated with glucose metabolism. We tested the hypothesis that ucOC levels are associated with indices of glucose metabolism in chronic hemodialysis patients with abnormalities of bone metabolism.
  
  
  METHODS
  Serum ucOC, bone alkaline phosphatase (BAP, a bone formation marker), and tartrate-resistant acid phosphatase-5b (TRACP-5b, a bone resorption marker) were measured in 189 maintenance hemodialysis patients (96 diabetics and 93 non-diabetics), and their relationships with glucose metabolism were examined.
  
  
  RESULTS
  ucOC correlated positively with BAP (ρ = 0.489, p < 0.0001), TRACP-5b (ρ = 0.585, p < 0.0001) and intact parathyroid hormone (iPTH; ρ = 0.621, p < 0.0001). Serum ucOC levels in the diabetic patients were lower than those of non-diabetic patients (p < 0.001), although there were no significant differences in serum BAP or TRACP-5b between diabetic and non-diabetic patients. Serum ucOC correlated negatively with plasma glucose (ρ = -0.303, p < 0.0001), hemoglobin A1C (ρ = -0.214, p < 0.01), and glycated albumin (ρ = -0.271, p < 0.001), although serum BAP or TRACP-5b did not. In multiple linear regression analysis, log [plasma glucose], log [hemoglobin A1C], and log [glycated albumin] were associated significantly with log [ucOC] after adjustment for age, gender, hemodialysis duration, and body mass index but were not associated with log [BAP], log [TRACP-5b], or log [intact PTH].
  
  
  CONCLUSIONS
  Increased levels of serum ucOC, which were associated with bone metabolism markers, were inversely associated with indices of glucose metabolism in hemodialysis patients.
authors.affiliation: Kidney Center, Shirasagi Hospital, Osaka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Okuno
authors.forename: E
authors.initials: E
authors.lastname: Ishimura
authors.forename: N
authors.initials: N
authors.lastname: Tsuboniwa
authors.forename: K
authors.initials: K
authors.lastname: Norimine
authors.forename: K
authors.initials: K
authors.lastname: Yamakawa
authors.forename: T
authors.initials: T
authors.lastname: Yamakawa
authors.forename: S
authors.initials: S
authors.lastname: Shoji
authors.forename: K
authors.initials: K
authors.lastname: Mori
authors.forename: Y
authors.initials: Y
authors.lastname: Nishizawa
authors.forename: M
authors.initials: M
authors.lastname: Inaba
mesh_terms: D000135:Acid Phosphatase / Q000097:blood; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications; D003928:Diabetic Nephropathies / Q000097:blood / Q000150:complications; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D017127:Glycation End Products, Advanced; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood*; D006435:Renal Dialysis; D012709:Serum Albumin / Q000378:metabolism; D000071681:Tartrate-Resistant Acid Phosphatase; D000093423:Glycated Serum Albumin
chemical_list: D000135:Acid Phosphatase; D000469:Alkaline Phosphatase; D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D007527:Isoenzymes; D015675:Osteocalcin; D012709:Serum Albumin; D000071681:Tartrate-Resistant Acid Phosphatase; D000093423:Glycated Serum Albumin; C000605510:ACP5 protein, human