Graduate Institute of Clinical Medicine, College of Medicines, Kaohsiung Medical University, Kaohsiung, Taiwan.
Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Dis Markers. 2020 Apr 21;2020:8641749. doi: 10.1155/2020/8641749. eCollection 2020.
Patients undergoing hemodialysis experience a greater risk of cognitive impairment than the general population, but limited data elucidates the biomarkers on this. We evaluated the association of bone turnover markers on cognitive function among 251 prevalent hemodialysis enrollees in a cross-sectional study.
251 hemodialysis patients (median age = 57.8, 55% men) and 37 control subjects (mean age = 61.2, 56% men) without a prior stroke or dementia diagnosis were enrolled. Serum concentrations of 8 bone markers were analyzed as the association of cognitive function (Montreal Cognitive Assessment (MoCA) and Cognitive Abilities Screening Instrument (CASI)) using linear regression analysis.
A lower cognitive function was noted in hemodialysis patients compared to control subjects. The receptor activator of nuclear factor kappa-B ligand (RANKL) was the only bone marker found to be associated with cognitive function (MoCA and CASI tests) in hemodialysis patients without a prior stroke or dementia diagnosis. In stepwise multiple linear regression analysis, the association remained significant in MoCA ( = 1.14, 95% CI 0.17 to 2.11) and CASI ( = 3.06, 95% CI 0.24 to 5.88). Short-term memory ( = 0.52, 95% CI 0.01 to 1.02), mental manipulation ( = 0.51, 95% CI 0.05 to 0.96), and abstract thinking ( = 0.57, 95% CI 0.06 to 1.09) were the significant subdomains in the CASI score related to RANKL.
Serum RANKL levels were potentially associated with better cognitive function in hemodialysis patients. Further large-scale and prospective studies are needed to confirm our findings.
与普通人群相比，接受血液透析的患者认知障碍的风险更高，但相关生物标志物的数据有限。我们在一项横断面研究中评估了 251 名接受血液透析的患者的骨转换标志物与认知功能之间的关系。
共纳入 251 名血液透析患者（中位年龄=57.8 岁，55%为男性）和 37 名对照受试者（平均年龄=61.2 岁，56%为男性），他们均无先前的中风或痴呆诊断。使用线性回归分析，对 8 种骨标志物的血清浓度与认知功能（蒙特利尔认知评估量表（MoCA）和认知能力筛查工具（CASI））之间的关系进行分析。
与对照受试者相比，血液透析患者的认知功能较低。核因子 kappa-B 配体受体激活剂（RANKL）是唯一一种与无先前中风或痴呆诊断的血液透析患者认知功能（MoCA 和 CASI 测试）相关的骨标志物。在逐步多元线性回归分析中，这种关联在 MoCA 中仍然显著（=1.14，95%CI 0.17 至 2.11）和 CASI（=3.06，95%CI 0.24 至 5.88）。短期记忆（=0.52，95%CI 0.01 至 1.02）、心理操作（=0.51，95%CI 0.05 至 0.96）和抽象思维（=0.57，95%CI 0.06 至 1.09）是与 RANKL 相关的 CASI 评分的显著子领域。
血清 RANKL 水平可能与血液透析患者的认知功能较好相关。需要进一步的大规模前瞻性研究来证实我们的发现。
