CKD Stages, Bone Metabolism Markers, and Cortical Porosity Index: Associations and Mediation Effects Analysis

Chronic kidney disease (CKD) has a significant negative impact on bone health. However, the mechanisms of cortical bone deterioration and cortical porosity enlargement caused by CKD have not been fully described. We therefore examined the association of CKD stages with cortical porosity index (PI),...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Yan Xiong, Tongxiang He, Yanan Wang, Weiyin Vivian Liu, Shuang Hu, Yao Zhang, Donglin Wen, Bowen Hou, Yitong Li, Peisen Zhang, Jianyi Liu, Fan He, Xiaoming Li
Formato: article
Lenguaje:EN
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://doaj.org/article/37096a8643084f0c95841a3f3e9648d9
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:37096a8643084f0c95841a3f3e9648d9
record_format dspace
spelling oai:doaj.org-article:37096a8643084f0c95841a3f3e9648d92021-11-05T12:42:10ZCKD Stages, Bone Metabolism Markers, and Cortical Porosity Index: Associations and Mediation Effects Analysis1664-239210.3389/fendo.2021.775066https://doaj.org/article/37096a8643084f0c95841a3f3e9648d92021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.775066/fullhttps://doaj.org/toc/1664-2392Chronic kidney disease (CKD) has a significant negative impact on bone health. However, the mechanisms of cortical bone deterioration and cortical porosity enlargement caused by CKD have not been fully described. We therefore examined the association of CKD stages with cortical porosity index (PI), and explored potential mediators of this association. Double-echo ultrashort echo-time magnetic resonance imaging (UTE MRI) provides the possibility of quantifying cortical porosity in vivo. A total of 95 patients with CKD stages 2-5 underwent 3D double-echo UTE-Cones MRI (3.0T) of the midshaft tibia to obtain the PI. PI was defined as the ratio of the image signal intensity of a sufficiently long echo time (TE) to the shortest achievable TE. Parathyroid hormone (PTH), β-CrossLaps (β-CTX), total procollagen type I amino-terminal propeptide (T-P1NP), osteocalcin (OC), 25-hydroxyvitamin D (25OHD), and lumbar bone mineral density (BMD) were measured within one week of the MRI. Partial correlation analysis was performed to address associations between PI, eGFR and potential mediators (PTH, β-CTX, T-P1NP, OC, 25OHD, BMD, and T-score). Multiple linear regression models were used to assess the association between CKD stages and PI value. Then, a separate exploratory mediation analysis was carried out to explore the impact of CKD stages and mediators on the PI value. The increasing CKD stages were associated with a higher PI value (Ptrend < 0.001). The association of CKD stages and PI mediated 34.4% and 30.8% of the total effect by increased PTH and β-CTX, respectively. Our study provides a new idea to monitor bone health in patients with CKD, and reveals the internal mechanism of bone deterioration caused by CKD to some extent.Yan XiongTongxiang HeYanan WangWeiyin Vivian LiuShuang HuYao ZhangDonglin WenBowen HouYitong LiPeisen ZhangJianyi LiuFan HeXiaoming LiFrontiers Media S.A.articlechronic kidney diseaseCKD-MBDUltrashort TEporosity indexcortical porositymediation analysisDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution DOAJ
collection DOAJ
language EN
topic chronic kidney disease
CKD-MBD
Ultrashort TE
porosity index
cortical porosity
mediation analysis
Diseases of the endocrine glands. Clinical endocrinology
RC648-665
spellingShingle chronic kidney disease
CKD-MBD
Ultrashort TE
porosity index
cortical porosity
mediation analysis
Diseases of the endocrine glands. Clinical endocrinology
RC648-665
Yan Xiong
Tongxiang He
Yanan Wang
Weiyin Vivian Liu
Shuang Hu
Yao Zhang
Donglin Wen
Bowen Hou
Yitong Li
Peisen Zhang
Jianyi Liu
Fan He
Xiaoming Li
CKD Stages, Bone Metabolism Markers, and Cortical Porosity Index: Associations and Mediation Effects Analysis
description Chronic kidney disease (CKD) has a significant negative impact on bone health. However, the mechanisms of cortical bone deterioration and cortical porosity enlargement caused by CKD have not been fully described. We therefore examined the association of CKD stages with cortical porosity index (PI), and explored potential mediators of this association. Double-echo ultrashort echo-time magnetic resonance imaging (UTE MRI) provides the possibility of quantifying cortical porosity in vivo. A total of 95 patients with CKD stages 2-5 underwent 3D double-echo UTE-Cones MRI (3.0T) of the midshaft tibia to obtain the PI. PI was defined as the ratio of the image signal intensity of a sufficiently long echo time (TE) to the shortest achievable TE. Parathyroid hormone (PTH), β-CrossLaps (β-CTX), total procollagen type I amino-terminal propeptide (T-P1NP), osteocalcin (OC), 25-hydroxyvitamin D (25OHD), and lumbar bone mineral density (BMD) were measured within one week of the MRI. Partial correlation analysis was performed to address associations between PI, eGFR and potential mediators (PTH, β-CTX, T-P1NP, OC, 25OHD, BMD, and T-score). Multiple linear regression models were used to assess the association between CKD stages and PI value. Then, a separate exploratory mediation analysis was carried out to explore the impact of CKD stages and mediators on the PI value. The increasing CKD stages were associated with a higher PI value (Ptrend < 0.001). The association of CKD stages and PI mediated 34.4% and 30.8% of the total effect by increased PTH and β-CTX, respectively. Our study provides a new idea to monitor bone health in patients with CKD, and reveals the internal mechanism of bone deterioration caused by CKD to some extent.
format article
author Yan Xiong
Tongxiang He
Yanan Wang
Weiyin Vivian Liu
Shuang Hu
Yao Zhang
Donglin Wen
Bowen Hou
Yitong Li
Peisen Zhang
Jianyi Liu
Fan He
Xiaoming Li
author_facet Yan Xiong
Tongxiang He
Yanan Wang
Weiyin Vivian Liu
Shuang Hu
Yao Zhang
Donglin Wen
Bowen Hou
Yitong Li
Peisen Zhang
Jianyi Liu
Fan He
Xiaoming Li
author_sort Yan Xiong
title CKD Stages, Bone Metabolism Markers, and Cortical Porosity Index: Associations and Mediation Effects Analysis
title_short CKD Stages, Bone Metabolism Markers, and Cortical Porosity Index: Associations and Mediation Effects Analysis
title_full CKD Stages, Bone Metabolism Markers, and Cortical Porosity Index: Associations and Mediation Effects Analysis
title_fullStr CKD Stages, Bone Metabolism Markers, and Cortical Porosity Index: Associations and Mediation Effects Analysis
title_full_unstemmed CKD Stages, Bone Metabolism Markers, and Cortical Porosity Index: Associations and Mediation Effects Analysis
title_sort ckd stages, bone metabolism markers, and cortical porosity index: associations and mediation effects analysis
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/37096a8643084f0c95841a3f3e9648d9
work_keys_str_mv AT yanxiong ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
AT tongxianghe ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
AT yananwang ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
AT weiyinvivianliu ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
AT shuanghu ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
AT yaozhang ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
AT donglinwen ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
AT bowenhou ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
AT yitongli ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
AT peisenzhang ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
AT jianyiliu ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
AT fanhe ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
AT xiaomingli ckdstagesbonemetabolismmarkersandcorticalporosityindexassociationsandmediationeffectsanalysis
_version_ 1718444280794578944