Nowak Z, Tłustochowicz W, Wańkowicz Z
Z Kliniki Nefrologii ze Stacja Dializ Centralnego Szpitala Klinicznego WAM w Warszawie.
Pol Merkur Lekarski. 2000 Dec;9(54):822-5.
Frequency of osteoporosis in patients on dialysis with respect to the optimal Region of Interest (ROI) has not been established. Frequency of this complication varies in different studies, especially because of no agreement according to the optimal ROI. We studied 71 patients: 32 on CAPD and 39 on HD (31F, 40m. age mean 56 +/- 29) on dialysis for 3 to 81 months. BMD was measured using dual energy X-ray densitometry (DXA) in L1-L4 segment of the vertebral column, femoral neck and forearm. The results of the BMD were presented as T-score in the standard deviation of the mean peak bone mass according to WHO criteria. Males and females were evaluated separately. Depending on the ROI, osteoporosis was diagnosed in 20 to 68% of women and in 2 to 40% of men. In females the most sensitive region of interest appeared to be forearm, in males it was proximal part of the femur. In these ROI's the lowest values of bone mineral density in both genders were found in patients with the level of iPTH higher than 200 pg/ml. We did not find any significant difference in BMD between patients on CAPD and HD. Values of bone mineral density were not related to the duration of dialysis therapy. On the results of our study it has been concluded, that optimal region of interest for BMD evaluation in dialysed patients depends on gender of the patient and functional status of parathyroid glands but is not related to either the method or duration of dialysis therapy.
关于透析患者骨质疏松症的发生频率与最佳感兴趣区域（ROI）之间的关系尚未明确。在不同研究中，这种并发症的发生频率有所不同，尤其是由于对于最佳ROI尚无统一标准。我们研究了71例患者：32例接受持续性非卧床腹膜透析（CAPD），39例接受血液透析（HD）（31例女性，40例男性，平均年龄56±29岁），透析时间为3至81个月。使用双能X线骨密度仪（DXA）测量腰椎L1-L4节段、股骨颈和前臂的骨密度。根据世界卫生组织标准，骨密度结果以相对于平均峰值骨量标准差的T值表示。对男性和女性分别进行评估。根据ROI不同，20%至68%的女性和2%至40%的男性被诊断为骨质疏松症。在女性中，最敏感的感兴趣区域似乎是前臂，在男性中则是股骨近端。在这些ROI区域，甲状旁腺激素（iPTH）水平高于200 pg/ml的患者，其骨密度在两性中均为最低。我们未发现CAPD患者和HD患者的骨密度有任何显著差异。骨密度值与透析治疗时间无关。根据我们的研究结果得出结论，透析患者骨密度评估的最佳感兴趣区域取决于患者性别和甲状旁腺功能状态，但与透析方法或透析时间无关。
