García-Nieto Victor, Navarro Juan F, Monge Margarita, García-Rodríguez Victoria E
Pediatric Nephrology Unit, Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Canary Islands, Spain.
Nephron Clin Pract. 2003;94(4):c89-93. doi: 10.1159/000072491.
BACKGROUND/AIMS: Idiopathic hypercalciuria (IH) is associated with a decreased bone mineral density (BMD) both in children and adults. It is being increasingly recognized that IH may be a contributing factor to osteopenia and/or osteoporosis in adults. We studied BMD in girls with IH and in their mothers, also affected with IH, in order to evaluate the influence of genetic background on bone mass in the setting of IH.
BMD was evaluated in 40 girls with IH and in their premenopausal mothers from whom they had inherited this disease. Urinary creatinine and calcium were measured by standard laboratory methods. BMD was determined by dual X-ray absorptiometry scanning of the lumbar spine (LS) and the femoral neck (FN), and values are expressed as Z- and T-scores.
A Z-score of <-1 at the LS was found in 42.5% of the girls, whilst in the mothers, a Z score of <-1 at the LS and/or FN was observed in 47.5% and a T-score of <-1 at the LS and/or FN in 62.5%. The Z-score at the LS was significantly lower in girls and their mothers compared to controls, although this finding did not apply for the Z-score at the FN in the mothers. Z-scores in the girls of mothers with osteopenia were significantly lower or there was a trend for the score to be lower than in the girls of mothers with normal BMD. There was a significant relationship between the Z-score of the girls and the T-score at the LS in the mothers (r = 0.32, p < 0.05).
We have observed a high prevalence of osteopenia in our population affected by IH, both in girls and in their mothers. We suggest that BMD should be measured during the third or fourth decades of life in those individuals with nephrolithiasis or with children diagnosed as having IH.
背景/目的:特发性高钙尿症(IH)在儿童和成人中均与骨矿物质密度(BMD)降低有关。人们越来越认识到,IH可能是成人骨质减少和/或骨质疏松症的一个促成因素。我们研究了患有IH的女孩及其同样患有IH的母亲的骨密度,以评估遗传背景在IH情况下对骨量的影响。
对40名患有IH的女孩及其绝经前患有此病的母亲进行了骨密度评估。采用标准实验室方法测量尿肌酐和钙。通过双能X线吸收法扫描腰椎(LS)和股骨颈(FN)来测定骨密度,其值以Z值和T值表示。
42.5%的女孩腰椎Z值<-1,而在母亲中,47.5%的母亲腰椎和/或股骨颈Z值<-1,62.5%的母亲腰椎和/或股骨颈T值<-1。与对照组相比,女孩及其母亲的腰椎Z值显著更低,尽管母亲股骨颈的Z值并非如此。母亲患有骨质减少的女孩的Z值显著更低,或者有低于母亲骨密度正常的女孩的Z值的趋势。女孩的Z值与母亲腰椎的T值之间存在显著相关性(r = 0.32,p < 0.05)。
我们观察到,在受IH影响的人群中,女孩及其母亲的骨质减少患病率都很高。我们建议,对于患有肾结石或其子女被诊断患有IH的个体,应在其三四十岁时测量骨密度。