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NDT Advance Access published online on June 10, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp262
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


The relationship between adipokines, osteocalcin and bone quality in chronic kidney disease

Justine Bacchetta1,2,3, Stéphanie Boutroy2,3, Fitsum Guebre-Egziabher3,4,5, Laurent Juillard3,4,6, Jocelyne Drai3,5,7, Solenne Pelletier2,4, Michel Richard3,7, Anne Charrié3,6,8, Marie Christine Carlier3,7, Roland Chapurlat2,3, Maurice Laville3,4,6 and Denis Fouque3,4,5

1 Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Bron 2 INSERM 831 3 Université de Lyon 4 Département de Néphrologie, Hôpital Edouard Herriot 5 INSERM 870 6 INSERM ERI 22 7 Département de Biologie, Hospices Civils de Lyon, Lyon 8 EA 3738, Oullins, France

Correspondence and offprint requests to: Denis Fouque; E-mail: denis.fouque{at}chu-lyon.fr



  Abstract

Objectives. Osteocalcin, a small peptide secreted by osteoblasts, has been recently described as a circulating hormone involved in the regulation of energy metabolism. In addition, experimental data suggest a regulation of adipocytes by bone, with a stimulation of adiponectin synthesis by osteocalcin and an inverse relationship between serum adiponectin level and bone mineral density (BMD). However, this relationship has not been explored during chronic kidney disease (CKD).

Methods. Osteocalcin, adiponectin and leptin were prospectively measured in a cohort of 61 CKD patients. A new non-invasive 3D bone imaging technique was performed (high-resolution peripheral quantitative computed tomography, HR-pQCT), measuring volumetric BMD (vBMD) and microarchitecture parameters at the distal tibia.

Results. Patients’ mean age was 67.2 ± 13.9 years and mean GFR 33 ± 12 mL/min/1.73 m2. We found a positive association between serum osteocalcin and adiponectin (r = 0.29, P = 0.021). Univariate analysis showed inverse correlations between serum adiponectin and total vBMD (r = –0.33, P = 0.01), cortical thickness (r = –0.34, P = 0.008) and trabecular vBMD (r = –0.27, P = 0.04). These associations remained significant in multivariate analysis between serum adiponectin and total vBMD, cortical vBMD and cortical thickness.

Conclusion. We report for the first time an inverse relationship between bone density and adiponectin, as well as a positive association between osteocalcin and adiponectin in CKD II–IV patients.

Keywords: adiponectin; bone imaging; chronic kidney disease; HR-pQCT; osteocalcin

Received for publication: 21.12.08
Accepted in revised form: 7. 5.09


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