Bone health in autosomal dominant polycystic kidney disease (ADPKD) patients after kidney transplantation.
Bone health in autosomal dominant polycystic kidney disease (ADPKD) patients after kidney transplantation.
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DOI：
10.1016/j.bonr.2023.101655
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发表时间：
2023-06
期刊：
影响因子：
2.5
通讯作者：
Chebib, Fouad T.
中科院分区：
文献类型：
--
作者：
Zubidat, Dalia;Hanna, Christian;Randhawa, Amarjyot K.;Smith, Byron H.;Chedid, Maroun;Kaidbay, Daniel-Hasan N.;Nardelli, Luca;Mkhaimer, Iraman G.;Neal, Reem M.;Madsen, Charles D.;Senum, Sarah R.;Gregory, Adriana V.;Kline, Timothy L.;Zoghby, Ziad M.;Broski, Stephen M.;Issa, Naim S.;Harris, Peter C.;Torres, Vicente E.;Sfeir, Jad G.;Chebib, Fouad T.
ADPKD由PKD 1或PKD 2的致病性变体引起，编码多囊蛋白-1和-2蛋白。在动物模型中，多囊蛋白在成骨细胞和软骨细胞中表达，并且功能丧失与低骨矿物质密度（BMD）和体积相关。然而，尚不清楚这些变异是否影响ADPKD患者的骨强度。在这里，我们检查了肾移植（KTx）后ADPKD的BMD。这项回顾性观察性研究检索了过去15年中接受KTx治疗的成人患者的数据。纳入了移植后可用髋关节和/或腰椎（LS）双能X射线吸收测定法（DXA）的患者。ADPKD患者（n = 340）按KTx时的年龄（±2岁）和性别与非糖尿病非ADPKD患者（n = 340）1：1匹配。与非ADPKD患者相比，ADPKD患者右侧全髋（TH）的BMD和T评分略高[BMD：0.951 vs. 0.897，p < 0.001; T评分：-0.62 vs.-0.99，p < 0.001]，左侧TH [BMD：0.960 vs. 0.893，p < 0.001; T评分：-0.60 vs.-1.08，p < 0.001]。在ADPKD和非ADPKD之间的右侧股骨颈（FN）[BMD：0.887 vs. 0.848，p = 0.001; T评分：-1.20 vs.-1.41，p = 0.01]和左侧FN [BMD：0.885 vs. 0.840，p < 0.001; T评分：-1.16 vs.-1.46，p = 0.001]。在LS水平，ADPKD与非ADPKD相比具有相似的BMD和较低的T评分[BMD：1.120 vs. 1.126，p = 0.93; T评分：-0.66 vs.-0.23，p = 0.008]。在调整抢先KTx后，ADPKD患者在TH和FN中继续具有较高的BMD T评分。我们的研究结果表明，在皮质骨而非松质骨占主导地位的部位，ADPKD患者的DXA BMD高于非ADPKD患者。在ADPKD患者中保留皮质骨BMD的临床益处需要在未来的研究中探索。肾移植术后检测ADPKD组和非ADPKD组的骨密度。ADPKD患者股骨颈和全髋的BMD和T评分较高，但腰椎的T评分较低。这项研究表明，与非ADPKD患者相比，ADPKD患者在移植后保留了皮质骨BMD
ADPKD is caused by pathogenic variants in PKD1 or PKD2, encoding polycystin-1 and -2 proteins. Polycystins are expressed in osteoblasts and chondrocytes in animal models, and loss of function is associated with low bone mineral density (BMD) and volume. However, it is unclear whether these variants impact bone strength in ADPKD patients. Here, we examined BMD in ADPKD after kidney transplantation (KTx). This retrospective observational study retrieved data from adult patients who received a KTx over the past 15 years. Patients with available dual-energy X-ray absorptiometry (DXA) of the hip and/or lumbar spine (LS) post-transplant were included. ADPKD patients (n = 340) were matched 1:1 by age (±2 years) at KTx and sex with non-diabetic non-ADPKD patients (n = 340). Patients with ADPKD had slightly higher BMD and T-scores at the right total hip (TH) as compared to non-ADPKD patients [BMD: 0.951 vs. 0.897, p < 0.001; T-score: −0.62 vs. -0.99, p < 0.001] and at left TH [BMD: 0.960 vs. 0.893, p < 0.001; T-score: −0.60 vs. -1.08, p < 0.001], respectively. Similar results were found at the right femoral neck (FN) between ADPKD and non-ADPKD [BMD: 0.887 vs. 0.848, p = 0.001; T-score: −1.20 vs. -1.41, p = 0.01] and at left FN [BMD: 0.885 vs. 0.840, p < 0.001; T-score: −1.16 vs. -1.46, p = 0.001]. At the LS level, ADPKD had a similar BMD and lower T-score compared to non-ADPKD [BMD: 1.120 vs. 1.126, p = 0.93; T-score: −0.66 vs. -0.23, p = 0.008]. After adjusting for preemptive KTx, ADPKD patients continued to have higher BMD T-scores in TH and FN. Our findings indicate that BMD by DXA is higher in patients with ADPKD compared to non-ADPKD patients after transplantation in sites where cortical but not trabecular bone is predominant. The clinical benefit of the preserved cortical bone BMD in patients with ADPKD needs to be explored in future studies. BMD was examined in ADPKD and non-ADPKD after kidney transplantation. ADPKD patients had higher BMD and T-scores at the femoral neck and total hip but lower T-scores in the lumbar spine. This study suggests that ADPKD patients have preserved cortical bone BMD compared to non-ADPKD patients after transplantation
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影响因子：
4.1
作者：
Hou, Bo;Kolpakova-Hart, Elona;Olsen, Bjorn R.
通讯作者：
Olsen, Bjorn R.
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影响因子：
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作者：
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通讯作者：
Edna, TH
影响因子：
6.1
作者：
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通讯作者：
El-Zoghby, Ziad M.
影响因子：
15.9
作者：
Hopp, Katharina;Ward, Christopher J.;Harris, Peter C.
通讯作者：
Harris, Peter C.