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Abstract: PO0403

Advanced Glycation End Products Are Related with Cortical Bone Quality and Increased Risk for Fractures in CKD Patients

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Roza, Noemi Angelica Vieira, Universidade Estadual de Campinas, Campinas, SP, Brazil
  • da Silva Quadros, Kelcia Rosana, Universidade Estadual de Campinas, Campinas, SP, Brazil
  • Esteves, André Barros Albuquerque, Universidade Estadual de Campinas, Campinas, SP, Brazil
  • Franca, Renata Almeida, Universidade Estadual de Campinas, Campinas, SP, Brazil
  • Dominguez, Wagner, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Furukawa, Luzia Naoko Shinohara, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • de Oliveira, Rodrigo B., Universidade Estadual de Campinas, Campinas, SP, Brazil
Background

The risk of bone fractures is higher in chronic kidney disease (CKD) patients than general population. We aim to investigate the relationships between advanced glycation end-products (AGEs) and cortical bone in a cohort of CKD patients.

Methods

86 CKD patients (stages 3-4, N=26; hemodialysis, N=32; peritoneal dialysis, N=28) were included. AGEs levels were measured in serum (pentosidine and glycated hemoglobin), in skin (by AGE-Reader device) and in cortical bone by immunohistochemistry; receptor activator of nuclear factor kappa-Β (RANK) and its ligand (RANKL) and SOST mRNA expression were evaluated by real-time PCR. Bone histomorphometry was performed to measure cortical porosity, thickness and volume. Fracture risk was predicted using FRAX tool.

Results

Age was 51±13 years; 48 (56%) were male, 41 (48%) Caucasian and 16 (19%) diabetics; dialysis vintage was 21 (10-44) months. AGEs levels in skin were 3.0±0.7 AU (reference: <2.0 AU), serum pentosidine 71 (44–121) pmol/mL and glycated hemoglobin 5.4 (5-6)%; cortical bone volume, thickness and porosity were 22.3±9.8 μm2, 619±213 μm and 1.55 (0.9-2.7)%, respectively. AGEs levels in skin were correlated with age (R=0.538; P=0.0001), risk for major osteoporotic fracture (R=0.562; P=0.0001) and hip fractures (R=0.49; P=0.0001). The mean area of AGEs deposits in the cortical bone was 5.4 (3-12.1)%; cortical thickness were negatively correlated with serum pentosidine levels (R=-0.27; P=0.02) and age (R=-0.235; P=0.04); cortical porosity were positively correlated with glycated hemoglobin (R=0.278; p=0.02), SOST mRNA expression (R=0.321; p=0.03), RANKL mRNA expression (R=0.414; p=0.004). Finally, RANK mRNA expression was correlated with serum pentosidine levels (R=0.304; p=0.045).

Conclusion

AGEs were detected in cortical bone and skin of CKD patients and correlates with their risk for osteoporotic fractures. Serum pentosidine levels were associated with low thickness of cortical bone. Cortical porosity was associated with serum glycated hemoglobin levels, SOST and RANKL mRNA expression. RANK was positively influenced by serum pentosidine levels. Together these data point to a direct relationship between AGEs and fractures in patients with CKD.

Funding

  • Government Support - Non-U.S.