Polak-Jonkisz Dorota, Zwolińska Danuta, Bednorz Renata, Owczarek Henryk, Nahaczewska Wiesława
Pol Merkur Lekarski. 2002 Apr;12(70):257-60.
Bone disorders resulting from abnormalities in mineral are common in patients with predialytic stage of chronic renal failure (CRF). Disturbances associated with: phosphate excretions, vitamin D3 metabolism, hypocalcemia, increased parathyroid hormone (PTH) and acid-base disturbances lead to bone pathology know as renal osteodystrophy (RO). Estimation of tempo turnover make possible markers, of which concentration means oneself in urine and in serum. The aim of this study was to estimate the urinary carboxy-terminal telopeptide of type I collagen as a index of bone resorption and osteocalcin as a marker of bone formation in correlation with intact PTH (iPTH) in predialytic children. The study group consisted of 39 children aged 6-17 y. All children were divided into 2 groups: I--21 predialytic pts; II--18 healthy children. The I group was divided into 2 subgroups: Ia--pts with normal range of iPTH; Ib--pts with higher range of iPTH. All patients were tested: for serum concentrations of: calcium (Ca), inorganic phosphorus (P), iPTH, OST; and for urinary CrossLaps (corrected with urinary creatinine).
In subgroup Ib revealed correlation between OST and iPTH (p < 0.05); and between CrossLaps and OST (p = 0.05).
The results of investigation on OST and CrossLaps as bone metabolism markers in predialytic children revealed that evaluating highly specific biochemical parameters of bone turnover is useful in assessing the clinical status of that metabolism. The knowledge of correlation between levels of bone turnover markers and clinical status of a child might help in taking appropriate therapeutic decision and in preventing renal osteodystrophy.
矿物质异常导致的骨病在慢性肾衰竭(CRF)透析前阶段的患者中很常见。与磷酸盐排泄、维生素D3代谢、低钙血症、甲状旁腺激素(PTH)升高以及酸碱平衡紊乱相关的干扰会导致骨病理状态,即肾性骨营养不良(RO)。骨转换速度的评估借助于一些标志物得以实现,这些标志物的浓度可在尿液和血清中检测到。本研究的目的是评估I型胶原羧基末端肽作为骨吸收指标以及骨钙素作为骨形成标志物,并将其与透析前儿童的完整PTH(iPTH)进行相关性分析。研究组由39名6 - 17岁的儿童组成。所有儿童被分为两组:I组——21名透析前患者;II组——18名健康儿童。I组又分为两个亚组:Ia组——iPTH在正常范围内的患者;Ib组——iPTH在较高范围内的患者。所有患者均接受检测:血清中钙(Ca)、无机磷(P)、iPTH、骨钙素(OST)的浓度;以及尿液中交联C端肽(用尿肌酐校正)。
在Ib亚组中,OST与iPTH之间存在相关性(p < 0.05);交联C端肽与OST之间存在相关性(p = 0.05)。
对透析前儿童骨代谢标志物OST和交联C端肽的研究结果表明,评估骨转换的高度特异性生化参数有助于评估该代谢的临床状态。了解骨转换标志物水平与儿童临床状态之间的相关性可能有助于做出适当的治疗决策并预防肾性骨营养不良。