Caudarella Renata, Vescini Fabio, Buffa Angela, Sinicropi Giuseppe, Rizzoli Elisabetta, La Manna Gaetano, Stefoni Sergio
Department of Nephrology, Dialysis and Kidney Transplant, Unit of Mineral Metabolism, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
J Nephrol. 2003 Mar-Apr;16(2):260-6.
Several authors have observed that idiopathic calcium stone formers show a bone mass reduction, which is more evident in those with idiopathic hypercalciuria. The aim of this work was the evaluation of osteopenia and osteoporosis rate in a group of idiopathic calcium stone formers. The influence of hypercalciuria, nutritional factors and anthropometric parameters on bone mass was evaluated in these patients as well.
We enrolled 196 idiopathic calcium stone formers; 102 males, and 94 females. All subjects underwent a metabolic study. BMC and BMD were evaluated as well as QUS.
Males showed greater weight, height, BMI, densitometric values and plasma creatinine, uric acid, urea, sodium, magnesium, GFR and urinary osmolarity than females. Moreover males excreted more uric acid, urea, creatinine, sulphate, phosphate, oxalate and citrate than females. The prevalence of osteopenia and osteoporosis, according to T-score, was 54% and 14% respectively. Hypercalciuria was demonstrated in 21.7% of the patients. Hypercalciuric men showed a higher excretion of urea, phosphate, sulphate and magnesium.
Our results confirm the importance of QUS in the evaluation of stone formers' bone mass. Anthropometric characteristics and dietary habits seem to play a role in bone loss. We did not demonstrate any influence of hypercalciuria on bone mass. Although the pathogenesis of bone loss in stone formers still remains unclear, it can be hypothesized that a slight degree of metabolic acidosis, probably of alimentary origin, may be involved in the reduction of bone mass.
几位作者观察到特发性钙结石形成者存在骨量减少，这在特发性高钙尿症患者中更为明显。本研究的目的是评估一组特发性钙结石形成者的骨质减少和骨质疏松发生率。同时还评估了高钙尿症、营养因素和人体测量参数对这些患者骨量的影响。
我们纳入了196例特发性钙结石形成者；其中男性102例，女性94例。所有受试者均接受了代谢研究。评估了骨矿物质含量（BMC）、骨密度（BMD）以及定量超声（QUS）。
男性在体重、身高、体重指数（BMI）、骨密度值以及血浆肌酐、尿酸、尿素、钠、镁、肾小球滤过率（GFR）和尿渗透压方面均高于女性。此外，男性排泄的尿酸、尿素、肌酐、硫酸盐、磷酸盐、草酸盐和柠檬酸盐也比女性多。根据T值，骨质减少和骨质疏松的患病率分别为54%和14%。21.7%的患者存在高钙尿症。高钙尿症男性的尿素、磷酸盐、硫酸盐和镁排泄量更高。
我们的结果证实了QUS在评估结石形成者骨量方面的重要性。人体测量特征和饮食习惯似乎在骨质流失中起作用。我们未发现高钙尿症对骨量有任何影响。尽管结石形成者骨质流失的发病机制仍不清楚，但可以推测，可能源于饮食的轻度代谢性酸中毒可能与骨量减少有关。
