VITAMIN D STATUS, PARATHYROID HORMONE AND INFLAMMATION IN HEMODIALYSIS PATIENTS
HADJA FATIMA TBAHRITI
Laboratoire de Nutrition Clinique et Métabolique, Faculté des Sciences de la Nature et de la Vie, Université d’Oran1 Ahmed Ben Bella, Oran 31100, Algérie.
LAKHDAR ZEMOUR
Service d’Épidémiologie, Etablissement Hospitalier Universitaire (EHU) d’Oran, Oran 31037, Algérie.
AMAR MESSAOUDI
Service de Biochimie, Etablissement Hospitalier Universitaire (EHU) d’Oran, Oran 31037, Algérie.
KHEDIDJA MEKKI *
Laboratoire de Nutrition Clinique et Métabolique, Faculté des Sciences de la Nature et de la Vie, Université d’Oran1 Ahmed Ben Bella, Oran 31100, Algérie.
*Author to whom correspondence should be addressed.
Abstract
Background: Disorders of mineral and bone metabolism are common in patients with chronic kidney disease especially in hemodialysis patients. It possible that 25-hydroxyvitamin D could play an important role in both inflammation and bone metabolism.
Aim: To analyze and assess the relationship between markers of bone metabolism and those of inflammation in hemodialysis patients.
Methods: A cross-sectional study was conducted in 120 hemodialysis patients and 82 healthy control subjects. Bone metabolism was assessed by measurement of 25-hydroxyvitamin D, parathyroid hormone, calcium and phosphorus using an immunological and biochemical methods. The inflammatory status (pro-inflammatory cytokines and C-reactive protein) was determined using an immunosorbent assay kit (Cayman). Differences between groups were performed using SPSS 20.0 and data were expressed as the mean ± SD.
Results: Compared to control group, we noted a decrease in Vitamin D and calcium in hemodialysis patients. An increase in parathyroid hormone, phosphorus, pro-inflammatory cytokines (Tumor Necrosis Factor-alpha, Interleukin-1beta and Interleukin-6) and in C-reactive protein was noted in hemodialysis patients. We found a negative correlation between levels of Vitamin D and parathyroid hormone. However, parathyroid hormone was negatively correlated with calcium and positively correlated with phosphate. On the other hand, we found a negative correlation between levels of Tumor Necrosis Factor-alpha and Vitamin D. Moreover, level of Tumor Necrosis Factor-alpha was positively correlated with that of parathyroid hormone.
Conclusion: Inflammation causes bone metabolic disturbances and disorders in hemodialysis patients.
Keywords: Bone metabolism, inflammation, hemodialysis, 25-hydroxyvitamin d, parathyroid hormone, pro-inflammatory cytokines