Abstract: Objectives Osteoporosis is associated with peripheral artery disease (PAD) in populations, but the relationship is scarcely studied in maintenance hemodialysis (MHD) patients. The ankle-brachial index (ABI) is used to diagnose PAD and is a strong predictor for cardiovascular mortality in MHD patients. This study aims to explore the relationship between bone mineral density (BMD) and ABI in MHD patients. Methods A total of 84 non-diabetic MHD patients were included in this cross-sectional study. An ABI-form device was used to measure the patient’s ABI. Calcaneal BMD was measured by ultrasound bone densitometer. Other
clinical and laboratory data were also collected. Results Patients were grouped according to ABI: low group (ABI＜0.9), normal group (0.9≤ ABI ≤1.4), and high group (ABI＞1.4). Patients with low or high ABI were present in 30% of the patients. ANOVA analysis showed that there were significant differences among
low group, normal group and high group in age (73.1±11.9, 61.4±11.3 and 72.3±8.4 years, respectively; F= 9.196, P＜0.001), serum C reactive protein (CRP) (30.8±75.3, 5.3±7.1 and 48.4±101.0 mg/L, respectively; F= 4.192, P=0.019), and BMD (-2.4±0.7, -0.9±1.0, -1.1±1.5, respectively; F=14.385, P＜0.001). Univariate correlation showed that PAD was positively associated with age (r=0.43, P＜0.001), serum albumin (r=-0.281, P= 0.010), CRP (r=0.298, P=0.006), and BMD (r=- 0.423, P＜0.001). Multivariate regression analysis showed that age (β=0.013, 95% CI 0.004~0.023, P＜0.001) and BMD (β= -0.153, 95% CI -0.243~-0.064, P＜0.001) were the independent determinants for PAD. Conclusion The prevalence of PAD is high in MHD patients. Osteoporosis is related to PAD, suggesting that osteoporosis is a strong predictor for cardiovascular mortality in MHD patients.