Hyperparathyroidism Is Responsible for the Increased Levels of Osteocalcin in Patients with Normally Functioning Kidney Grafts

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Abstract
Osteocalcin or bone Gla protein (BGP) is the most abundant noncollagenous protein of the skeleton. Serum BGP levels are thought to provide a valuable index of bone formation. We measured serum BGP and other parameters of mineral metabolism in 68 patients with functioning kidney grafts. The duration of the graft ranged from 1 to 131 months (mean 23). Serum BGP was positively correlated with parathyroid hormone (r = 0.56, p < 0.001). BGP was inversely correlated with glomerular filtration rate (r= –0.44, p < 0.001) and with the total cumulative dose of corticosteroids received after transplantation (r= –0.26, p < 0.05). No correlation was observed between BGP and 1,25(OH)2D, nor between BGP and serum aluminum. All patients with increased BGP in the presence of normal renal function had persistent hyperparathyroidism. The activity of the parathyroid glands and corticosteroid treatment seem to be the main pathophysiological factors influencing BGP levels after successful kidney grafting.