Effect of Serum Fibroblast Growth Factor‐23, Matrix G la Protein and F etuin‐ A in Predicting Osteoporosis in Maintenance Hemodialysis Patients

This study is aimed at exploring the role of serum fibroblast growth factor‐23 (FGF ‐23), matrix G la (MGP) and F etuin‐ A in the calcium‐phosphate metabolism and estimate the value of serum FGF ‐23, MGP and F etuin‐ A levels in predicting osteoporosis in maintenance hemodialysis ( MHD ) patients. This study included 64 patients who receive hemodialysis in our hospital. The serum FGF ‐23, MGP and F etuin‐ A were analyzed by enzyme‐linked immunosorbent assay ( ELlSA ). Bone mineral density ( BMD ) at the femoral neck was measured by dual‐energy X ‐ray absorptiometry. The 64 patients (30 males, 34 females, 60.6 ± 11.3 years of age) received an average of 6.88 ± 2.94 years of dialysis. Body mass index ( BMI) , K t/ V , dialysis vintage, patient age, serum levels of FGF ‐23, F etuin‐ A , bone isoenzyme of alkaline phosphatase ( ALP ‐ B ), and calcium were different in statistical significance among the three groups of patients in terms of normal bone mass ( N =  10), osteopenia ( N =  24), or osteoporosis ( N =  30). BMI , K t/ V , ALP ‐ B , dialysis vintage and serum F etuin‐ A level were identified as independent variables of femoral neck BMD by stepwise multiple regression analysis. The area under ROC curve showed that serum F etuin‐ A was useful for identifying osteoporosis in MHD patients. The cutoff value corresponding to the highest Y ouden's index was serum F etuin‐ A ≤89 μg/mL, which was defined as the optimal predictor of osteoporosis. Its sensitivity/specificity was 71%/77.8%. The incidence of osteoporosis is high in MHD patients. Serum F etuin‐ A level is closely correlated with osteoporosis and it may serve as a predictor of osteoporosis.