title: Effect of serum fibroblast growth factor-23, matrix Gla protein and Fetuin-A in predicting osteoporosis in maintenance hemodialysis patients.
abstract: This study is aimed at exploring the role of serum fibroblast growth factor-23 (FGF-23), matrix Gla (MGP) and Fetuin-A in the calcium-phosphate metabolism and estimate the value of serum FGF-23, MGP and Fetuin-A levels in predicting osteoporosis in maintenance hemodialysis (MHD) patients. This study included 64 patients who receive hemodialysis in our hospital. The serum FGF-23, MGP and Fetuin-A were analyzed by enzyme-linked immunosorbent assay (ELlSA). Bone mineral density (BMD) at the femoral neck was measured by dual-energy X-ray absorptiometry. The 64 patients (30 males, 34 females, 60.6 ± 11.3 years of age) received an average of 6.88 ± 2.94 years of dialysis. Body mass index (BMI), Kt/V, dialysis vintage, patient age, serum levels of FGF-23, Fetuin-A, bone isoenzyme of alkaline phosphatase (ALP-B), and calcium were different in statistical significance among the three groups of patients in terms of normal bone mass (N = 10), osteopenia (N = 24), or osteoporosis (N = 30). BMI, Kt/V, ALP-B, dialysis vintage and serum Fetuin-A level were identified as independent variables of femoral neck BMD by stepwise multiple regression analysis. The area under ROC curve showed that serum Fetuin-A was useful for identifying osteoporosis in MHD patients. The cutoff value corresponding to the highest Youden's index was serum Fetuin-A ≤ 89 μg/mL, which was defined as the optimal predictor of osteoporosis. Its sensitivity/specificity was 71%/77.8%. The incidence of osteoporosis is high in MHD patients. Serum Fetuin-A level is closely correlated with osteoporosis and it may serve as a predictor of osteoporosis.
authors.affiliation: Division of Nephrology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Wu
authors.forename: Dong-Mei
authors.initials: DM
authors.lastname: Xiao
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Fan
authors.forename: Xian-Wu
authors.initials: XW
authors.lastname: Ye
authors.forename: Jian-Ying
authors.initials: JY
authors.lastname: Niu
authors.forename: Yong
authors.initials: Y
authors.lastname: Gu
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000469:Alkaline Phosphatase / Q000378:metabolism; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D002118:Calcium / Q000378:metabolism; D002135:Calcium-Binding Proteins / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D016326:Extracellular Matrix Proteins / Q000097:blood*; D005260:Female; D005272:Femur Neck / Q000378:metabolism; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D006435:Renal Dialysis; D012680:Sensitivity and Specificity; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*; D000097568:Matrix Gla Protein
chemical_list: D000469:Alkaline Phosphatase; D002118:Calcium; D002135:Calcium-Binding Proteins; D016326:Extracellular Matrix Proteins; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors; D060749:alpha-2-HS-Glycoprotein; D000097568:Matrix Gla Protein; C000717427:FGF23 protein, human
keywords: Bone mineral density; Calcium and phosphate metabolism; Fetuin-A; Fibroblast growth factor 23; Maintenance hemodialysis; Matrix Gla protein