Association between increased serum osteoprotegerin levels and improvement in bone mineral density after parathyroidectomy in hemodialysis patients

Cai Mei Zheng, Pauling Chu, Chia Chao Wu, Wen Ya Ma, Kuo Chin Hung, Yung Ho Hsu, Yuh Feng Lin, Liang Kuang Diang, Kuo Cheng Lu

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Secondary hyperparathyroidism (SHPT) is a common complication in chronic renal disease. Osteoprotegerin (OPG), an extracellular cytokine receptor secreted by osteoblasts, can promote bone formation by inhibiting the function of osteoclasts. Hemodialysis (HD) patients have elevated serum OPG levels. OPG secretion can be suppressed with high parathyroid hormone (PTH) levels. HD patients with refractory SHPT can benefit from parathyroidectomy (PTX) treatment, but the changes of serum OPG, bone turnover markers and bone mineral density (BMD) following PTX in HD patients remain unclear. In this study, patients on maintenance HD who received PTX for refractory SHPT (n = 28) were prospectively followed for 1 year. Serum intact PTH (iPTH), alkaline phosphatase (Alk-P), and OPG were measured serially; BMD was measured pre-PTX and at 1 year after PTX. After PTX, serum iPTH levels reduced profoundly. Serum Alk-P levels increased rapidly, peaking at 2 weeks post-PTX, while serum OPG levels gradually increased at 2 weeks after PTX and peaked at 2 months. BMD improved in both femoral neck (FN; cancellous and cortical bone) and lumbar spine (LS; cancellous bone). Higher baseline iPTH levels were associated with greater FN and LS BMD improvements at one year after PTX. The increment of serum OPG was correlated with the increase in LS BMD, implying that inhibition of osteoclastic bone resorption may improve BMD within the irst year after PTX. These indings suggest that PTX removes the suppressive effects of high PTH on OPG secretion, resulting in the increased serum OPG levels that may contribute to BMD improvement.

Original languageEnglish
Pages (from-to)19-27
Number of pages9
JournalTohoku Journal of Experimental Medicine
Volume226
Issue number1
DOIs
Publication statusPublished - 2012

Fingerprint

Osteoprotegerin
Parathyroidectomy
Bone Density
Minerals
Renal Dialysis
Bone
Serum
Secondary Hyperparathyroidism
Parathyroid Hormone
Alkaline Phosphatase
Refractory materials
Cytokine Receptors
Bone Remodeling
Femur Neck
Osteoclasts
Bone Resorption
Osteoblasts
Chronic Renal Insufficiency
Osteogenesis
Spine

Keywords

  • Alkaline phosphatase
  • Bone mineral density
  • Hemodialysis
  • Osteoprotegerin
  • Parathyroidectomy

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Association between increased serum osteoprotegerin levels and improvement in bone mineral density after parathyroidectomy in hemodialysis patients. / Zheng, Cai Mei; Chu, Pauling; Wu, Chia Chao; Ma, Wen Ya; Hung, Kuo Chin; Hsu, Yung Ho; Lin, Yuh Feng; Diang, Liang Kuang; Lu, Kuo Cheng.

In: Tohoku Journal of Experimental Medicine, Vol. 226, No. 1, 2012, p. 19-27.

Research output: Contribution to journalArticle

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