Endocrine Abstracts (2009) 20 P245

Body composition and bone mineral density in hemodialysis patients

Zorica Rasic-Milutinovic1, Gordana Perunicic-Pekovic2, Olivera Stojanovic3, Jelena Tica1, Vesna Popovic1, Marina Vujovic1 & Zoran Gluvic1


1Department of Endocrinology, University Hospital Zemun/Belgrade, Belgrade, Serbia; 2Department of Nephrology and Hemodialysis, University Hospital Zemun/Belgrade, Belgrade, Serbia; 3Medical School Belgrade, Institute for Rehabilitation, Belgrade, Serbia.


Aim/hypothesis: Chronic renal failure maintenance hemodialysis (HD) patients are at risk for low bone mineral density (BMD) and fractures. Parathyroid hormone (iPTH) plays a pivotal role in the pathophysiology of uremic bone disease, but in healthy population body weight and particularly body composition are more important determinants of bone mass.

Patients and methods: We studied BMD (results were recorded as g/cm2) and T score using DEXA osteometer (DTX-200 Osteometer) on forearm in 42 patients (19 females, 15 post-menopausal and 23 males), who had been on HD for a mean of 42.3±23.2 months. Body composition was evaluated by bioelectrical impedance analysis and quantifies body fat, lean body mass and total body water (FAT%; LBM%; TBW%) using a TBF-110 Body Fat Analyser (Tanita).

Results: The prevalence of osteoporosis was high (84%) in women, and we found significant negative correlation between BMD and age and positive correlation with LBM%. In the multiple regression analysis LBM% was most significant, independent predictor of BMD in women (β coefficient=1.047, P=0.001). The prevalence of osteoporosis was also high (76%) in men, and besides negative correlation between BMD and age we found positive correlation between bone mass and iPTH, as well as with LBM%. In the multiple regression analysis, only iPTH independently predicted BMD in men (β coefficient=0.812, P=0.02).

We conclude that the lean body mass compartment is the most important component of body composition that determines BMD, particularly in post-menopausal HD women. This study suggests also that secondary hyperparathyroidism, confirmed in our group of patients, seems to be independent predictor of bone mass in HD men.

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