Abstract：
BACKGROUND: Activin A has been shown to enhance osteoclast activity and its inhibition results in bone growth. The potential role of activin A as a marker of chronic kidney disease-mineral bone disease (CKD-MBD) and its relationship with other markers has not been studied in children with CKD.
METHODS: A cross sectional study was conducted among 40 children aged 2 to 18 years with CKD (Stage 2 to 5; 10 in each stage) and 40 matched controls. Activin A, cathepsin K, FGF-23, PTH, serum calcium, phosphorous and alkaline phosphatase in both groups were measured and compared. The correlation of activin A and markers of CKD-MBD was studied. A p value of < 0.05 was considered significant.
RESULTS: The mean age of children with CKD was 9.30 ± 3.64 years. Mean levels of activin A in cases were 485.55 pg/ml compared to 76.19 pg/ml in controls (p < 0.001). FGF-23 levels in cases were 133.18 pg/ml while in controls it was 6.93 pg/ml (p < 0.001). Mean levels of cathepsin K were also significantly higher in cases as compared to controls. There was a progressive increase in activin A and cathepsin K levels with increasing stage of CKD. Activin A had a significant positive correlation with serum creatinine (r = 0.51; p < 0.001).
CONCLUSIONS: Activin A levels progressively rise with advancing CKD stage. These findings suggest that activin A can be a potential early marker of CKD-MBD in children.
METHODS: A cross sectional study was conducted among 40 children aged 2 to 18 years with CKD (Stage 2 to 5; 10 in each stage) and 40 matched controls. Activin A, cathepsin K, FGF-23, PTH, serum calcium, phosphorous and alkaline phosphatase in both groups were measured and compared. The correlation of activin A and markers of CKD-MBD was studied. A p value of < 0.05 was considered significant.
RESULTS: The mean age of children with CKD was 9.30 ± 3.64 years. Mean levels of activin A in cases were 485.55 pg/ml compared to 76.19 pg/ml in controls (p < 0.001). FGF-23 levels in cases were 133.18 pg/ml while in controls it was 6.93 pg/ml (p < 0.001). Mean levels of cathepsin K were also significantly higher in cases as compared to controls. There was a progressive increase in activin A and cathepsin K levels with increasing stage of CKD. Activin A had a significant positive correlation with serum creatinine (r = 0.51; p < 0.001).
CONCLUSIONS: Activin A levels progressively rise with advancing CKD stage. These findings suggest that activin A can be a potential early marker of CKD-MBD in children.
摘要：
背景:激活素A已显示增强破骨细胞活性并且其抑制导致骨生长。激活素A作为慢性肾脏病-矿物质骨病（CKD-MBD）标志物的潜在作用及其与其他标志物的关系尚未在CKD儿童中进行研究。
方法：对40名年龄在2至18岁的CKD儿童（2至5期；每个阶段10名）和40名匹配对照进行了横断面研究。激活素A,组织蛋白酶K,FGF-23,PTH,血清钙，测量并比较两组的磷和碱性磷酸酶。研究了激活素A与CKD-MBD标志物的相关性。<0.05的p值被认为是显著的。
结果：CKD患儿的平均年龄为9.30±3.64岁。与对照组的76.19pg/ml相比,病例中活化素A的平均水平为485.55pg/ml(p<0.001)。病例中的FGF-23水平为133.18pg/ml,而对照组为6.93pg/ml(p<0.001)。与对照相比,在病例中组织蛋白酶K的平均水平也显著较高。随着CKD阶段的增加，激活素A和组织蛋白酶K水平逐渐增加。激活素A与血清肌酐呈显著正相关(r=0.51;p<0.001)。
结论：激活素A水平随着CKD分期的增加而逐渐升高。这些发现表明，激活素A可能是儿童CKD-MBD的潜在早期标志物。
方法：对40名年龄在2至18岁的CKD儿童（2至5期；每个阶段10名）和40名匹配对照进行了横断面研究。激活素A,组织蛋白酶K,FGF-23,PTH,血清钙，测量并比较两组的磷和碱性磷酸酶。研究了激活素A与CKD-MBD标志物的相关性。<0.05的p值被认为是显著的。
结果：CKD患儿的平均年龄为9.30±3.64岁。与对照组的76.19pg/ml相比,病例中活化素A的平均水平为485.55pg/ml(p<0.001)。病例中的FGF-23水平为133.18pg/ml,而对照组为6.93pg/ml(p<0.001)。与对照相比,在病例中组织蛋白酶K的平均水平也显著较高。随着CKD阶段的增加，激活素A和组织蛋白酶K水平逐渐增加。激活素A与血清肌酐呈显著正相关(r=0.51;p<0.001)。
结论：激活素A水平随着CKD分期的增加而逐渐升高。这些发现表明，激活素A可能是儿童CKD-MBD的潜在早期标志物。
