Abstract: Objective To analyze the changes of serum intact parathyroid hormone (iPTH) and 25-hydroxyvitamin D3 [25(OH)D3] levels and their related factors in maintenance hemodialysis (MHD) patients with or without diabetes mellitus. Method A total of 180 MHD patients without parathyroidectomy and treated
in the period from Jan. to Dec. 2015 in the Blood Purification Center of the First Affiliated Hospital of Nanjing Medical University were enrolled in this study. They were divided into DH group (MHD patients with diabetes) and NDH group (MHD patients without diabetes). Their clinical data, including general information, dialysis age, history of diabetes, and laboratory data were compared between the two groups to analyze the influence factors for serum iPTH and 25(OH)D3 levels in these patients. Results Serum iPTH level was 219.7 (164.1～275.2) pg/ml in DH group significantly lower than the level of 500.39 (398.1～602.7) pg/ml in NDH group (Z=- 4.473, P＜0.001). Similarly, serum 25(OH)D3 level was also lower in DH group than in NDH group (30.9±16.0 pg/ml vs. 45.2±25.1 pg/ml, t=-3.327, P=0.001). Serum iPTH level was negatively correlated with history of diabetes (r=- 0.339, P＜0.001), and positively correlated with dialysis age (r=0.386, P＜0.001), serum phosphatase, (r=0.437, P＜0.001), alkaline phosphatase (r=0.426, P＜0.001) and 25-OH D3 (r=0.254, P=0.016). Multivariate linear regression analysis showed that history of diabetes (βa=-0.173, P=0.012) and dialysis age (βa=0.147, P=0.028) were the independent factors for iPTH. Serum 25-OH D3 level was negatively correlated with history of diabetes (r=-0.296, P=0.004), and positively correlated with dialysis age (r= 0.228, P=0.030), serum phosphatase (r=0.237, P=0.023), serum magnesium (r=0.286, P=0.007), serum albumin (r=0.263, P=0.012) and iPTH (r=0.254, P=0.016). Multivariate linear regression analysis showed that history of diabetes (βa=-0.317, P=0.004) was the independent factor for 25-OH D3. Conclusion The levels of iPTH and 25-OH D3 were significantly lower in NH group than in NDH group. History of diabetes was the independent factor for iPTH and 25-OH D3.

Key words: Uremia, Diabetes Mellitus, Parathyroid Hormone, 25 hydroxy vitamin D3, Hemodialysis