The Correlationbetween CTX And BMD With Abdominal Aortic Calcification In Patients With Secondary Hyperparathyroidism

Objective:The objective of the study is to investigate correlation between bone metabolism-cross laps(CTX),bone miner density(BMD)and abdominal aortic calcification(AAC).The subjects in this study are patients with secondary hyperparathyroidism requiring dialysis treatment.Methods:From May 2014 to January 2016,we collected 82 patients with intact parathyroid hormone(i PTH)levels of 300 pg/ml or more in China-Japan Friendship Hospital,all is about hemodialysis patients without surgical treatment.All subjects were underwent the measurement of BMD using dual X-ray absorptiometry(DXA)and AAC using lateral X-ray plain films of abdomen.Collected the demographic data,dialysis vintage and biochemical indicators of the subjects at the same time,including CTX,i PTH,calcium(Ca),phosphorus(P),et al.According to BMD,the patients were divided into 3 groups,the normal,osteopenia and osteoporosis group.AAC severity was classified as absent(AAC=0),mild(1≦AAC score≦5),moderate(6≦AACscore≦12),or severe(AAC score≧13).Results:1.We enrolled 82 dialysis patients with SHPT,41(48.78%)males,42(51.22%)females,with mean age 50.99±12.98(range=22-73),and mean dialysis vintage88.42±50.15(range=1.5-245).Our study revealed a high prevalence of AAC in chronic hemodialysis patients(63.41%),nearly onefourth of whom,presented with advanced calcification involving four segments.2.BMD was negatively orrelated with AAC(r=-0.46,P<0.001).3.According to AAC,age and dialysis vintage in calcified group was higher than non-calcified group(P <0.05),and CTX was lower(P<0.05).4.According to BMD,age in normal group was lower compared with osteopenia and osteoporosis group(P<0.05),and serum phosphorus was higher(P<0.05).Compared with normal and osteopenia group,25-Hydroxyvitamin D(25(OH)D)in osteoporosis group was lower(P<0.05).5.AAC was positively correlated with age(r=0.454,P<0.05),serum phosphorus(r=0.438,P<0.05),and negatively with CTX(r=-0.100,P=0.035),the degree of calcification was more severe in males(P<0.05),and has no relationship with smoking,hypertension,25(OH)D,TRACP et al.BMD was negatively with age((r=-0.020,P<0.05),CTX(r=-0.365,P<0.05),and women has a lower BMD than men(P<0.05)and has no relationship with smoking,hypertension,25(OH)D et al.Conclusion:1.There is significant negatively correlation between osteoporosis and artery calcification.2.Age and serum phosphorus level are risk factors of AAC and osteoporosis in patients with SHPT.3.The abdominal aortic calcification has strong correlation with serum CTX level,therefore serum CTX level may reflect the severity of abdominal artery calcification in dialysis patients with SHPT.