title: The relationship between the Spine Deformity Index, biochemical parameters of bone metabolism and vascular calcifications: results from the Epidemiological VERtebral FRACtures iTalian Study (EVERFRACT) in dialysis patients.
abstract: BACKGROUND
  The Spine Deformity Index (SDI) is a measure of vertebral fractures (VFs), providing information on both their number and severity.
  
  
  METHODS
  We evaluated the relationships between SDI and clinical, biochemical and arterial calcification parameters in 387 hemodialysis (HD) patients. VFs, assessed by quantitative vertebral morphometry, and vascular calcifications were identified in the same lateral spinal X-ray. To improve the detection of fracture severity, we created a corrected SDI (c-SDI), by dividing SDI for the number of VFs. We assessed routine biochemistry, bone-Gla-protein (BGP), undercaboxylated BGP (ucBGP), and matrix-Gla-protein (MGP).
  
  
  RESULTS
  VFs prevalence was 55.3%. HD patients with a SDI >1 were more frequently males (p<0.05), and had lower BGP (p<0.01). Patients with a c-SDI >1 had higher LDL-cholesterol (p<0.05) and lower ucBGP (p<0.05) and MGP (p<0.05). Calcifications of the abdominal aorta (AAoC) were more frequent in patients with SDI >1 (p<0.05) and with c-SDI >1 (p<0.05). Multivariate logistic regression showed that male sex (OR 1.86, CI 1.20-2.91), age (OR 1.03, CI 1.01-1.05) and albumin ≥3.5 g/dL (OR 0.54, CI 0.31-0.93) were predictors of a SDI >1. Age (OR 1.05, CI 1.03-1.07), LDL-cholesterol (OR 1.74, CI 1.04-2.92) and ucBGP (OR 0.35, CI 0.18-0.70) were associated with c-SDI >1.
  
  
  CONCLUSIONS
  We conclude that the severity of VFs was associated with age, atherogenic factors and bone metabolism markers.
authors.forename: Maria
authors.initials: M
authors.lastname: Fusaro
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gallieni
authors.forename: Marianna
authors.initials: M
authors.lastname: Noale
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tripepi
authors.forename: Davide
authors.initials: D
authors.lastname: Miozzo
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
authors.forename: Martina
authors.initials: M
authors.lastname: Zaninotto
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Guglielmi
authors.forename: Diego
authors.initials: D
authors.lastname: Miotto
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fabris
authors.forename: Antonio
authors.initials: A
authors.lastname: Piccoli
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Vilei
authors.forename: Stefania
authors.initials: S
authors.lastname: Sella
authors.forename: Paolo
authors.initials: P
authors.lastname: Morachiello
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Stoppa
authors.forename: Maurizio
authors.initials: M
authors.lastname: Rossini
authors.forename: Sandro
authors.initials: S
authors.lastname: Giannini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism*; D002135:Calcium-Binding Proteins / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood; D016326:Extracellular Matrix Proteins / Q000378:metabolism; D005260:Female; D006801:Humans; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000293:injuries; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015675:Osteocalcin / Q000737:chemistry / Q000378:metabolism; D015995:Prevalence; D006435:Renal Dialysis; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology*; D013904:Thoracic Vertebrae / Q000293:injuries; D061205:Vascular Calcification; D000097568:Matrix Gla Protein
chemical_list: D002135:Calcium-Binding Proteins; D008078:Cholesterol, LDL; D016326:Extracellular Matrix Proteins; D015675:Osteocalcin; D000097568:Matrix Gla Protein