Impaired secretion of parathyroid hormone is coherent to diabetic hemodialyzed patients

Diabetic bone disease is characterized by low bone turnover resulting from impaired secretion of parathyroid hormone (PTH). However, it was suggested that the difference in duration of hemodialysis (HD) therapy and age of pat ients between HD patients with and without diabetes mellitus (DM) may be re sponsible for a significant reduction in serum intact PTH (iPTH) level In H D patients with DM. The present study showed that although such major facto rs affecting PTH secretion as age, sex, HD duration, and serum calcium, pho sphate, and magnesium levels did not differ significantly between HD patien ts with and without DM, serum iPTH levels were still significantly lower in HD patients with than without DM. Among biochemical markers for bone metab olism, serum levels of intact osteocalcin (iOC) and deoxypyridinoline (DPD) were significantly lower in HD patients with than without DM, whereas seru m bone-specific alkaline phosphatase, pyridinoline, and beta -crosslaps did not differ significantly between the two groups of patients. In summary, o ur findings indicate that PTH secretion may be significantly impaired in HD patients with DM compared with those without DM, and serum iOC and DPD are bone markers sensitive enough to detect low bone turnover In HD patients w ith DM. (C) 2001 by the National Kidney Foundation, Inc.