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Abstract: The aim of the study was to assess skeletal status in diabetic and nondiabetic subjects with end-stage renal disease (ESRD). One hundred twenty-three patients with ESRD (57 patients with diabetes: 9 type 1 and 48 type 2) and 66 nondiabetic patients were evaluated. Control group comprised 1541 subjects (614 males and 927 females). Diabetes and/or renal insufficiency was the only reason of bone disease and, in control group, no factors known to influence bone metabolism (chronic diseases or prolonged medications) were noted. Skeletal status was evaluated by quantitative ultrasound measurements at the hand phalanges using DBM 1200 (IGEA, Carpi, Italy), which measures amplitude-dependent speed of sound (Ad-SoS [m/s]). Because of some differences in mean age in subgroups of patients and controls, comparisons were performed using values of Z-score. In all diabetic patients, Z-score was significantly higher compared with nondiabetics (p < 0.05). In all type 1 diabetes patients, Z-score was significantly lower than in all nondiabetic patients (p < 0.05) and in patients with type 2 diabetes (p < 0.001). Z-score was also significantly lower in type 2 diabetics than in nondiabetic females (p < 0.00001) but did not differ in males. Comparisons between Z-scores in controls and patients showed that Z-score in nondiabetic females was significantly lower than in female controls (p < 0.000001), and in nondiabetic males—diabetic type 2 males as well as females—Z-score did not differ vs. results in adequate control group. Z-score was significantly lower in patients with diabetes type 1 vs. all controls (p < 0.001). Correlation analysis showed in all nondiabetic patients that Z-score was negatively affected by duration time of dialysis (r = −0.37, p < 0.01) and parathyroid hormone (PTH) serum level (r = −0.35, p < 0.01). In patients with type 1 diabetes, only PTH influenced significantly Z-score (r = −0.76, p < 0.05) and, in patients with type 2 diabetes, no significant correlations were obtained. Subjects with type 1 diabetes seemed to be sensitive for skeletal disturbances in a course of renal insufficiency, whereas subjects with type 2 diabetes did not show such skeletal pathology as shown by ultrasound measurements at hand phalanges. (E-mail: osteolesna@poczta.onet.pl) [Copyright &y& Elsevier]

Abstract: In patients with end-stage renal disease (ESRD), bone disturbances are common. The aim of this study was to compare the bone mineral status in patients with ESRD, in patients post renal transplantation and in healthy controls. The groups were composed of 218 males and 126 females (ESRD), 43 males and 23 females (renal transplantation) and 614 males and 927 females (healthy controls). Skeletal status was evaluated by quantitative ultrasound measurements of the phalanges using a DBM 1200 (IGEA, Carpi, Italy), which measures the amplitude-dependent speed of sound (Ad-SoS) in m/s. Data analyses were performed with Statistica 6 for Windows (StatSoft, Inc., Tulsa, OK, USA). The Z-scores in gender subgroups were significantly lower in patients undergoing dialysis and after transplantation than in controls (p < 0.00001). The Z-scores did not differ between gender subgroups after transplantation and the Z-scores of dialyzed males were significantly better than in females (p < 0.00001). The mean value of Z-scores in patients after transplantation was significantly lower than in all patients with ESRD (p < 0.05) and in males (p < 0.01). The duration of dialysis negatively influenced the Ad-SoS; however, the time elapsed since transplantation did not. The cumulative corticosteroid dose did not correlate with skeletal variables. In conclusion, patients with ESRD treated with hemodialysis and postrenal transplantation patients, across both genders, were observed to have skeletal disturbances. (E-mail: osteolesna@poczta.onet.pl) [Copyright &y& Elsevier]