Associations of Bone Turnover Markers with Cognitive Function in Patients Undergoing Hemodialysis
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Bibliographic record
Abstract
Background . Patients undergoing hemodialysis experience a greater risk of cognitive impairment than the general population, but limited data elucidates the biomarkers on this. We evaluated the association of bone turnover markers on cognitive function among 251 prevalent hemodialysis enrollees in a cross-sectional study. Methods . 251 hemodialysis patients (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mtext>median</mml:mtext><mml:mtext> </mml:mtext><mml:mtext>age</mml:mtext><mml:mo>=</mml:mo><mml:mn>57.8</mml:mn></mml:math>, 55% men) and 37 control subjects (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mtext>mean</mml:mtext><mml:mtext> </mml:mtext><mml:mtext>age</mml:mtext><mml:mo>=</mml:mo><mml:mn>61.2</mml:mn></mml:math>, 56% men) without a prior stroke or dementia diagnosis were enrolled. Serum concentrations of 8 bone markers were analyzed as the association of cognitive function (Montreal Cognitive Assessment (MoCA) and Cognitive Abilities Screening Instrument (CASI)) using linear regression analysis. Results . A lower cognitive function was noted in hemodialysis patients compared to control subjects. The receptor activator of nuclear factor kappa-B ligand (RANKL) was the only bone marker found to be associated with cognitive function (MoCA and CASI tests) in hemodialysis patients without a prior stroke or dementia diagnosis. In stepwise multiple linear regression analysis, the association remained significant in MoCA (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mi>β</mml:mi><mml:mo>=</mml:mo><mml:mn>1.14</mml:mn></mml:math>, 95% CI 0.17 to 2.11) and CASI (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mi>β</mml:mi><mml:mo>=</mml:mo><mml:mn>3.06</mml:mn></mml:math>, 95% CI 0.24 to 5.88). Short-term memory (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mi>β</mml:mi><mml:mo>=</mml:mo><mml:mn>0.52</mml:mn></mml:math>, 95% CI 0.01 to 1.02), mental manipulation (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mi>β</mml:mi><mml:mo>=</mml:mo><mml:mn>0.51</mml:mn></mml:math>, 95% CI 0.05 to 0.96), and abstract thinking (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"><mml:mi>β</mml:mi><mml:mo>=</mml:mo><mml:mn>0.57</mml:mn></mml:math>, 95% CI 0.06 to 1.09) were the significant subdomains in the CASI score related to RANKL. Conclusions . Serum RANKL levels were potentially associated with better cognitive function in hemodialysis patients. Further large-scale and prospective studies are needed to confirm our findings.
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Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it