微炎症状态及血清PTH(1-84) BALP水平检测在维持性血液透析肾性骨病中的临床意义

doi:10.3969/j.issn.1006-6233.2023.06.012

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Abstract Objective: To analyze the clinical significance of micro-inflammatory state and serum levels of intact parathyroid hormone [PTH(1-84)] and bone-specific alkaline phosphatase (BALP) on patients with renal osteodystrophy undergoing maintenance hemodialysis (MHD). Methods: A total of 104 patients with MHD admitted to department of nephrology of the hospital from January 2019 to July 2022 were selected as the research subjects. According to the presence or absence of renal osteodystrophy, the patients were divided into renal osteodystrophy group (n=36) and non-renal osteodystrophy group (n=68). Another 50 healthy volunteers were enrolled as control group. The levels of micro-inflammatory state [C-reactive protein (CRP), interleukin-6 (IL-6), β₂-microglobulin (β₂-MG)] and bone turnover markers [PTH(1-84), BALP, osteoprotegerin (OPG)] were compared among the three groups at enrollment. Pearson correlation analysis was used to analyze the relationship between micro-inflammatory state and bone turnover markers in patients with renal osteodystrophy. Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of the above micro-inflammatory indicators and bone turnover markers on MHD with renal osteodystrophy. Results: The levels of serum CRP, IL-6 and β₂-MG in the three groups at enrollment were as follows: renal osteodystrophy group>non-renal osteodystrophy group>control group, with statistically significant differences (P<0.05). The levels of serum PTH(1-84), BALP and OPG in the three groups were shown as renal osteodystrophy group>non-renal osteodystrophy group>control group (P<0.05). Pearson correlation analysis showed that the level of serum IL-6 at enrollment in renal osteodystrophy group was positively correlated with PTH(1-84) (P<0.05), and β₂-MG was positively correlated with BALP (P<0.05). ROC curve revealed that serum CRP, IL-6, β₂-MG, PTH (1-84), BALP and OPG had good predictive efficiency in the diagnosis of MHD with renal osteodystrophy (with AUC, sensitivity and specificity of 0.769, 77.80% and 77.90% when CRP cutoff value was 18.41 mg/L, 0.791, 83.30% and 69.10% when IL-6 cutoff value was 243.53 pg/mL, 0.731, 73.90% and 70.28% when β₂-MG cutoff value was 5.605 mg/L, 0.839, 77.80% and 85.30% when PTH (1-84) cutoff value was 173.235 ng/L, 0.810, 94.40% and 64.70% when BALP cutoff value was 23.575 U/L and 0.826, 83.30% and 76.50% when OPG cutoff value was 365.93 pg/mL respectively). Conclusion: The levels of bone turnover markers [PTH(1-84), BALP, OPG] and micro-inflammatory indicators (CRP, IL-6, β₂-MG) are abnormally increased in patients with MHD, and they have good predictive efficiency in the diagnosis of MHD with renal osteodystrophy.

Key words： Maintenance hemodialysis Renal osteodystrophy Micro-inflammatory state Parathyroid hormone Bone-specific alkaline phosphatase

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	MAIERHABA Maimaiti
	WANG Ting
	PAREDANMU Tuohuti
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Cite this article:

MAIERHABA Maimaiti,WANG Ting,PAREDANMU Tuohuti, et al. The Clinical Significance of Microinflammatory Status and Serum PTH (1-84) and BALP Levels in Maintenance Hemodialysis Renal Bone Disease[J]. HeBei Med, 2023, 29(6): 941-946.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.06.012 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I6/941

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