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Abstract: SA-PO189

Bone Marrow Adiposity Is Associated With Aging and Markers of Bone Remodeling in Non-Dialysis CKD Patients

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Salgado, Joao Victor, Division of Nephrology, Federal University of São Paulo, São Paulo, São Paulo, Brazil
  • Carvalho, Aluizio B., Division of Nephrology, Federal University of São Paulo, São Paulo, São Paulo, Brazil
  • Canziani, Maria Eugenia F., Division of Nephrology, Federal University of São Paulo, São Paulo, São Paulo, Brazil
Background

Patients with moderate to severe CKD are associated with greater bone marrow adiposity than those with normal renal function or mild CKD. However, little is known about the factors related to marrow fat accumulation, particularly in CKD patients. We evaluated the relationship between bone marrow adiposity and, clinical and laboratory parameters in CKD patients.

Methods

This was a post hoc analysis of 37 transiliac bone biopsy samples obtained from CKD stage 2-5ND patients (age 50±11 yrs., 68% male, 35% diabetes, GFR 34±17 ml/min/1.73m2). Serum concentrations of FGF21, sclerostin (Scl) and undercarboxylated osteocalcin (uOC) were measured by enzyme-linked immunosorbent assay. Quantitative histomorphometry of bone marrow adipocytes was performed including adipose area (Ad.Ar/Ma.Ar, %), adipocyte number (N.Ad/T.Ar, n°/mm2) and adipocyte width (Ad.Wi, μm).

Results

Ad.Ar/Ma.Ar was positively correlated with age (r=0.33, p=0.04), FGF21 (r=0.41, p=0.01) and osteoprotegerin (r=0.41, p=0.01). N.Ad/T.Ar was negatively correlated with TG/HDL-c ratio (r=-0.35, p=0.03) and Scl (r=-0.37, p=0.02). Ad.Wi showed a positive correlation with age (r=0.43, p<0.01), FGF21 (r=0.33, p=0.04), uOC (r=0.55, p<0.01), Scl (r=0.57, p<0.01), total cholesterol (r=0.34, p=0.04), LDL-cholesterol (r=0.32, p=0.04), triglycerides (r=0.50, p<0.01), TG/HDL-c ratio (r=0.43, p<0.01) and a negative correlation with estimated GFR (r=-0.34, p=0.04). After adjustment for eGFR, the regression analyses showed that age, osteoprotegerin and sclerostin levels were independently associated with marrow adipocyte parameters.

Conclusion

Bone marrow adiposity was independently associated with aging and markers of bone remodeling in non-dialysis CKD patients.

Funding

  • Government Support – Non-U.S.