Body mass index is inversely associated with osteoblastic activity in patients undergoing hemodialysis.

Triggered by the association of malnutrition with the incidence of fractures in patients undergoing hemodialysis (HD), the present study evaluated whether the body mass index (BMI) is associated with serum markers of osteoblastic or osteoclastic activity in this population. The levels of the osteoblastic markers, total procollagen type-1 aminoterminal propeptide (P1NP) and osteocalcin (OC), the osteoclastic marker, ß-isomerized C-terminal cross-linked peptide of collagen type I (ß-CTx), and those of the intact parathyroid hormone (iPTH) were measured in the serum of 59 patients undergoing HD. iPTH, P1NP, OC and ß-CTx were intercorre-lated. BMI inversely correlated with the osteoblastic markers, P1NP and OC, but not with the osteoclastic marker, ß-CTx. Age negatively correlated with OC, ß-CTx and iPTH. The levels of P1NP, OC and ß-CTx were lower in patients with diabetes mellitus. BMI affected the osteoblastic markers independently of age, diabetes mellitus and iPTH. Thus, BMI inversely correlates with markers of osteoblastic activity in patients undergoing HD. However, other studies are required to confirm causality in this correlation. If confirmed, then enhancing osteoblastic activity by improving the nutritional status may become another therapeutic strategy against chronic kidney disease-mineral bone disease. [ABSTRACT FROM AUTHOR]