Szathmári M, Vásárhelyi B, Szabó M, Szabó A, Reusz G S, Tulassay T
First Department of Medicine, Semmelweis University, Budapest, Hungary.
Calcif Tissue Int. 2000 Dec;67(6):429-33. doi: 10.1007/s002230001193.
As the result of accelerated growth, the final height of infants born with low birth weight (LBW) is near to the normal. Limited data are available about the bone density and bone turnover just after completion of skeletal development. We have investigated the bone turnover and bone density in 49 apparently healthy young LBW men (age 19-21 years; 21 born small for gestational age (SGA) and 28 appropriate for gestational age (AGA)) and in 16 age-matched controls. Bone mineral density of lumbar spine, femoral neck, and radius midshaft, the markers of calcium homeostasis, biochemical parameters of bone turnover as serum osteocalcin (OC), and urinary pyridinoline (PYD) and deoxypyridinoline (DPD) levels were measured. Bone mineral densities of LBW subjects were not altered. Serum calcium (SGA: 2.44+/-0.15; AGA:2.41+/-0.17, control: 2.25+/-0.09 mmol/liter, P < 0.05), OC (SGA:23.4+/-9.9; AGA:20.8+/-7.6; control:13.3+/-4.6 ng/ml, P < 0.01), total alkaline phosphatase (AP) (SGA:201+/-61; AGA:193+/-81, control: 117+/-34 IU/liter, P < 0.01), and urinary DPD/creat (ln.values: SGA:3.10+/-0.48; AGA:3.17+/-0.46; control:2.58+/-0.57 nmol/mmol, P < 0.05) were higher, whereas fractional excretion of calcium (SGA:0.94+/-0.470; AGA: 1.03+/-0.51, control:1.31+/-0.75%, P < 0.05) was lower in both SGA and AGA groups. PTH and 25OHD were not different. Significant correlation was obtained between seCa, OC, AP, DPD and birth weight of the subjects, but feCa correlated inversely to the birth weight. It was concluded that the bone turnover of LBW men is accelerated, but well balanced in young adulthood. Further investigation is needed to describe the possible link between accelerated bone turnover and hormonal homeostasis of LBW subjects.
由于生长加速,低出生体重(LBW)婴儿的最终身高接近正常。关于骨骼发育完成后即刻的骨密度和骨转换的可用数据有限。我们研究了49名表面健康的年轻LBW男性(年龄19 - 21岁;21名小于胎龄儿(SGA)和28名适于胎龄儿(AGA))以及16名年龄匹配的对照者的骨转换和骨密度。测量了腰椎、股骨颈和桡骨中段的骨矿物质密度、钙稳态标志物、骨转换的生化参数如血清骨钙素(OC)以及尿吡啶啉(PYD)和脱氧吡啶啉(DPD)水平。LBW受试者的骨矿物质密度没有改变。血清钙(SGA:2.44±0.15;AGA:2.41±0.17,对照:2.25±0.09 mmol/升,P < 0.05)、OC(SGA:23.4±9.9;AGA:20.8±7.6;对照:13.3±4.6 ng/ml,P < 0.01)、总碱性磷酸酶(AP)(SGA:201±61;AGA:193±81,对照:117±34 IU/升,P < 0.01)以及尿DPD/肌酐(对数数值:SGA:3.10±0.48;AGA:3.17±0.46;对照:2.58±0.57 nmol/mmol,P < 0.05)较高,而钙的分数排泄(SGA:0.94±0.470;AGA:1.03±0.51,对照:1.31±0.75%,P < 0.05)在SGA和AGA组中均较低。甲状旁腺激素(PTH)和25-羟基维生素D(25OHD)没有差异。受试者的血清钙(seCa)、OC、AP、DPD与出生体重之间存在显著相关性,但钙的分数排泄(feCa)与出生体重呈负相关。得出的结论是,LBW男性的骨转换加速,但在成年早期处于良好平衡状态。需要进一步研究来描述LBW受试者骨转换加速与激素稳态之间可能的联系。