Polak-Jonkisz Dorota, Zwolińska Danuta, Bednorz Renata, Owczarek Henryk, Szymańska Anna, Nahaczewska Wiesława
Department of Pediatric Nephrology, Medical University of Wrocław, Poland.
Med Sci Monit. 2003 Jan;9(1):CR19-23.
Biochemical and hormonal disturbances in calcium-phosphate storage accompanying chronic renal failure (CRF) lead to the loss of bone mass and the destruction of bone microarchitecture. The aim of this study was to evaluate the serum levels of PICP (procollagen I carboxyterminal propeptide) and ICTP (carboxyterminal telopeptide of type I collagen) as markers of bone growth in CRF children treated conservatively.
MATERIAL/METHODS: 34 children (16 female and 18 males) with predialytic CRF, aged 6 to 18 years (average age 11.3+/-3.8 years) were included in the experimental group. The controls were 20 healthy age-matched children. The experimental subjects were divided into two subgroups, based on the blood level of intact PTH (iPTH). Subgroup Ia (n=7) consisted of children with normal serum concentrations of iPTH. Subgroup Ib (n=27) consisted of children with elevated serum concentrations of iPTH.
In group Ia characteristic correlations were found between OST (osteocalcin) and ICTP, and between creatinine and ICTP. In group Ib, positive correlations were found between iPTH and PICP, iPTH and ICTP, OST and ICTP, and ICTP and PICP. In this group no correlation was found between marker turnover and creatinine.
The results of our study of PICP and ICTP as markers of bone metabolism in children with CRF in the predialysis period indicate that their levels should be routinely monitored as specific biochemical parameters of bone structure.
慢性肾衰竭(CRF)伴随的钙磷储存生化及激素紊乱会导致骨量丢失和骨微结构破坏。本研究旨在评估血清I型前胶原羧基末端前肽(PICP)和I型胶原羧基末端肽(ICTP)水平,作为保守治疗的CRF儿童骨生长的标志物。
材料/方法:实验组纳入34例年龄6至18岁(平均年龄11.3±3.8岁)的透析前CRF儿童(16例女性,18例男性)。对照组为20例年龄匹配的健康儿童。根据完整甲状旁腺激素(iPTH)的血水平将实验对象分为两个亚组。亚组Ia(n = 7)由血清iPTH浓度正常的儿童组成。亚组Ib(n = 27)由血清iPTH浓度升高的儿童组成。
在Ia组中,骨钙素(OST)与ICTP之间以及肌酐与ICTP之间发现了特征性相关性。在Ib组中,iPTH与PICP、iPTH与ICTP、OST与ICTP以及ICTP与PICP之间发现了正相关性。在该组中,标志物周转率与肌酐之间未发现相关性。
我们对PICP和ICTP作为透析前期CRF儿童骨代谢标志物的研究结果表明,应将其水平作为骨结构的特定生化参数进行常规监测。