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Abstract: TH-PO164

Marrow Adipocytes Do Not Suppress Mineralization by Osteocytes in Hemodialysis Patients

Session Information

Category: Bone and Mineral Metabolism

  • 502 Bone and Mineral Metabolism: Clinical

Authors

  • Yajima, Aiji, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Hanafusa, Norio, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Kakuta, Takatoshi, Tokai Daigaku Igakubu Fuzoku Hachioji Byoin, Hachioji, Tokyo, Japan
  • Tsuchiya, Ken, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Nitta, Kosaku, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan
Background

Increased marrow adipocytes induce low bone turnover in non-CKD and CKD subjects (Bone Rep. 21, Endocr Rev. 19). And bone marrow adiposity is increased in CKD subjects (Osteoporos Int. 15). It was revealed recently that the osteocyte plays the important roles which affect bone turnover and osteocytic perilacunar/canalicular turnover in dialysis patients (Bone. 18, Kidney Int. 18, JBMR Plus. 19).
In this research, the relationship between marrow adiposity and mineralization by osteocytes after parathyroidectomy for secondary hyperparathyroidism (IIHPT) was investigated in hemodialysis (HD) patients.

Methods

Thirty one HD patients with IIHPT, including Group I (n = 15, Age; 56.1 ± 6.5 yr, duration of HD; 17.7 ± 5.9 yr, serum intact PTH (iPTH); 1482.5 ± 860.7 pg/mL) and Group II (n = 16, Age; 56.7 ± 9.1 yr, duration of HD; 13.4 ± 8.2 yr, serum iPTH; 1330.4 ± 659.2 pg/mL) were investigated. These patients were treated with total parathyroidectomy with immediate autotransplantation (PTX) and received 2.0µg/day of alfacalcidol for four weeks after PTX. The patients underwent transiliac bone biopsies before and 1 week (Group I) and 4 weeks (Group II) after PTX. Oc.S/BS (%), Ob.S/BS (%), BFR/BS (mm3/mm2/yr), hypomineralized bone area (HM.B.Ar/B.Ar; %) and marrow adipocyte area (Ad.Ar/Ma.Ar; %) were measured in cancellous bone.

Results

In Group I, serum iPTH decreased from 1482.5 ± 860.7 to 43.2 ± 81.6 pg/mL. Oc.S/BS significantly decreased and Ob.S/BS increased after PTX. And Ad.Ar/Ma.Ar increased from 13.6 ± 8.2 to 25.8 ± 12.4 % (p = 0.002) after PTX.
In Group II, serum iPTH decreased from 1330.4 ± 659.2 to 20.6 ± 24.8 pg/mL. Oc.S/BS decreased from 4.4 ± 3.7 to 0.1 ± 0.5 % (p < 0.001) and Ob.S/BS also decreased from 22.3 ± 11.4 to 15.0 ± 17.2 % (p = 0.004) after PTX. BFR/BS was significantly lower than that of the other HD patients with IIHPT (n = 14, iPTH = 755.7 ± 341.5 pg/mL) (0.022 ± 0.014 vs. 0.051 ± 0.027 mm3/mm2/yr, p = 0.003). HM.B.Ar/B.Ar decreased from 17.0 ± 13.5 to 2.8 ± 3.4 % (p < 0.001) although Ad.Ar/Ma.Ar increased from 16.7 ± 11.2 to 26.6 ± 8.3 % (p = 0.030) after PTX in Group II.

Conclusion

Increased marrow adiposity was closely associated with low bone turnover, however, mineralization by osteocytes was not suppressed after PTX.

Funding

  • Private Foundation Support