Effect of RANKL on Lower Depressive Symptoms In Hemodialysis Patients.

IF 3.3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Calcified Tissue International Pub Date : 2024-08-01 Epub Date: 2024-06-15 DOI:10.1007/s00223-024-01215-2
Dong-Young Lee, Yerin Chung, Beom Kim, Jae-Hon Lee, Kangbaek Lee, Young Lee, Yu Ho Lee, Shin Young Ahn, Yang Gyun Kim, Hyeon Seok Hwang, Ju-Young Moon, Jae-Hong Ryoo, Kayla M Teopiz, Roger S McIntyre
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Abstract

Depression and osteoporosis are common diseases in dialysis patients. In addition, patients with osteoporosis are more susceptible to depression. Contrary to previous anti-osteoporosis agents, denosumab and romosozumab could be used in dialysis patients and have similar action mechanisms for blocking RANKL. RANKL causes bone resorption after binding RANKL, but binding with OPG leads to suppress of bone resorption. In recent mice study, inhibition of RANKL with denosumab improved depressive-like phenotype. Besides, it was found that OPG was associated with depression. Therefore, this study aimed to investigate the association of depressive symptoms with RANKL and OPG in hemodialysis patients. We conducted a cross-sectional study with a total of 172 hemodialysis patients. The participants were measured for plasma RANKL, OPG, MMP-2, and MMP-9 levels. Logistic regression analysis was performed to evaluate the effect of RANKL and OPG on the presence of depressive symptoms. The depressive symptoms were observed in 90 (52.3%) subjects. RANKL tertile 3 had negative association with BDI score (β - 4.527, 95% CI - 8.310 to - 0.743) in univariate analysis, and this association persisted even after multivariate adjustments (β - 5.603, 95% CI - 9.715 to -1.491) in linear regression. In logistic regression between RANKL tertiles and depressive symptoms, RANKL tertile 3 had significantly lower unadjusted OR (0.40, 95% CI 0.19-0.86), and multivariate-adjusted OR (0.31, 95% CI 0.12-0.82) for depressive symptoms. OPG was not significantly associated with depressive symptoms. Higher plasma RANKL concentrations were significantly associated with lower depressive symptoms in HD patients.Trial registration WHO registry, No. KCT0003281, date: January 12, 2017.

Abstract Image

RANKL对降低血液透析患者抑郁症状的影响
抑郁症和骨质疏松症是透析患者的常见疾病。此外,骨质疏松症患者更易患抑郁症。与以往的抗骨质疏松症药物不同,地诺单抗和罗莫索单抗可用于透析患者,它们阻断 RANKL 的作用机制相似。RANKL 与 RANKL 结合后会导致骨吸收,但与 OPG 结合则会抑制骨吸收。在最近的小鼠研究中,使用地诺单抗抑制 RANKL 可改善抑郁样表型。此外,研究还发现 OPG 与抑郁有关。因此,本研究旨在调查血液透析患者的抑郁症状与 RANKL 和 OPG 的关系。我们对 172 名血液透析患者进行了横断面研究。研究人员测量了参与者的血浆 RANKL、OPG、MMP-2 和 MMP-9 水平。研究人员进行了逻辑回归分析,以评估 RANKL 和 OPG 对抑郁症状的影响。90名受试者(52.3%)出现了抑郁症状。在单变量分析中,RANKL三等分 3 与 BDI 评分呈负相关(β - 4.527,95% CI - 8.310 至 - 0.743),在线性回归中,即使进行了多变量调整,这种相关性仍然存在(β - 5.603,95% CI - 9.715 至 -1.491)。在 RANKL 三分层与抑郁症状之间的逻辑回归中,RANKL 三分层的抑郁症状的未调整 OR(0.40,95% CI 0.19-0.86)和多变量调整 OR(0.31,95% CI 0.12-0.82)均显著降低。OPG与抑郁症状无明显相关性。较高的血浆RANKL浓度与HD患者较低的抑郁症状明显相关。试验注册WHO登记,编号:KCT0003281,日期:2017年1月12日。
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来源期刊
Calcified Tissue International
Calcified Tissue International 医学-内分泌学与代谢
CiteScore
8.00
自引率
2.40%
发文量
112
审稿时长
4-8 weeks
期刊介绍: Calcified Tissue International and Musculoskeletal Research publishes original research and reviews concerning the structure and function of bone, and other musculoskeletal tissues in living organisms and clinical studies of musculoskeletal disease. It includes studies of cell biology, molecular biology, intracellular signalling, and physiology, as well as research into the hormones, cytokines and other mediators that influence the musculoskeletal system. The journal also publishes clinical studies of relevance to bone disease, mineral metabolism, muscle function, and musculoskeletal interactions.
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