Abstract | UNLABELLED: Serum undercarboxylated osteocalcin (ucOC)/intact osteocalcin (iOC) ratio increased >1.0 in the patients undergoing hemodialysis, particularly in those with high bone turnover state. Consequently, serum ucOC/iOC ratio might lose its significance as a bone metabolic marker to indicate vitamin K deficiency in hemodialysis patients. INTRODUCTION: Serum intact osteocalcin (iOC), undercarboxylated OC (ucOC), and the ucOC/iOC ratio are considered clinically relevant indices in pre-dialysis chronic kidney disease (CKD) and hemodialysis (HD) patients, despite their accumulation in uremic serum. METHODS: RESULTS: Serum iOC and ucOC showed significantly negative correlations with estimated glomerular filtration rate in pre-dialysis CKD patients, although serum ucOC/iOC ratio did not correlate. Serum ucOC was significantly greater in HD patients than in pre-dialysis CKD patients, while serum iOC did not differ significantly, resulting in serum ucOC/iOC ratio >1.0 in 135 (71.4%) out of 189 HD patients. HD patients with high serum ucOC/iOC ratio (>1.0) had a significantly younger age and significantly higher values of body mass index, serum creatinine, albumin, phosphate, iPTH, and TRACP-5b than those with low ucOC/iOC ratio (≤ 1.0). The baseline iPTH and P1NP correlated with the changes of the ucOC/iOC ratio during the 2 days of the inter-dialytic period. Multivariate analysis showed that log [ucOC/iOC] in HD patients was significantly associated with log [iPTH], log [BAP], or log [ TRACP-5b]. CONCLUSIONS: Serum ucOC/iOC ratio >1.0 was observed in as high as 71.4% of HD patients, preferentially with high bone turnover state, in comparison with pre-dialysis CKD patients. These data suggested that serum ucOC/iOC ratio might lose its significance as a bone metabolic marker to indicate vitamin K deficiency in HD patients.
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Authors | Y Nagata, M Inaba, Y Imanishi, H Okazaki, S Yamada, K Mori, S Shoji, H Koyama, S Okuno |
Journal | Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
(Osteoporos Int)
Vol. 26
Issue 3
Pg. 1053-61
(Mar 2015)
ISSN: 1433-2965 [Electronic] England |
PMID | 25403902
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers
- Isoenzymes
- Parathyroid Hormone
- Osteocalcin
- Alkaline Phosphatase
- ACP5 protein, human
- Acid Phosphatase
- Tartrate-Resistant Acid Phosphatase
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Topics |
- Acid Phosphatase
(blood)
- Aged
- Alkaline Phosphatase
(blood)
- Biomarkers
(blood)
- Bone Remodeling
(physiology)
- Female
- Humans
- Isoenzymes
(blood)
- Male
- Middle Aged
- Osteocalcin
(blood)
- Parathyroid Hormone
(blood)
- Renal Dialysis
(adverse effects)
- Renal Insufficiency, Chronic
(blood, therapy)
- Risk Factors
- Tartrate-Resistant Acid Phosphatase
- Treatment Outcome
- Vitamin K Deficiency
(blood)
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