@article{oai:jichi-ir.repo.nii.ac.jp:00000007,
 author = {Saito, Osamu and Yanaka, Yuki and Saito, Takako and Takeda, Shinichi and Ito, Chiharu and Sasaki, Nobuhiro and Ando, Yasuhiro and Kusano, Eiji},
 journal = {自治医科大学紀要, Jichi Medical University Journal},
 month = {Mar},
 note = {Background: It is well known that type 2 diabetic patients easily have bone fracture regardless of normal-high bone mineral density. Otherwise, diabetic hemodialysis patients often have adynamic bone disease, but the precise mechanism underlying this disease remains unclear. Recently, osteoprotegerin (OPG) has been identified as a cytokine that inhibits osteoclast differentiation. The present study was undertaken to evaluate changes in serum OPG and other bone turnover markers in type 2 diabetic hemodialysis patients. We also evaluated the effect of type 2 diabetic change for mineral and bone disorder in hemodialysis patients.
Methods: The subjects were 18 diabetic patients and 34 non-diabetic patients who were receiving hemodialysis. All patients were male. Bone turnover markers, including serum OPG, intact osteocalcin (OC), intact parathyroid hormone (iPTH), tartrate-resistant acid phosphatase (TRAP), and alkaline phosphatase activity (ALP) were measured, and bone volume was determined as the speed of sound (SOS) in the calcaneus by quantitative heel ultrasound.
Results: The SOS value in diabetic patients was significantly smaller than that in non-diabetic patients. The serum OPG level in diabetic patients was significantly higher than that in non-diabetic patients, whereas serum iPTH, OC (a marker of bone formation) and TRAP (a marker of bone resorption) were significantly lower in diabetic patients. There were no significant differences in serum ALP, adjusted calcium, phosphate, and aluminum levels between the two groups.
Conclusion: Type 2 diabetic hemodialysis patients have low bone volume regardless of high levels of OPG and low levels of serum iPTH, OC, and TRAP. These findings suggest type 2 diabetes is a major factor which influence mineral and bone disorder in hemodialysis patients and the effect for bone might be different from the effect under normal kidney function.},
 pages = {1--10},
 title = {Changes in serum osteoprotegerin and bone turnover markers in type 2 diabetic hemodialysis patients},
 volume = {34},
 year = {2012}
}