Asaka M, Iida H, Entani C, Fujita M, Izumino K, Takata M, Seto H, Sasayama S
Second Department of Internal Medicine, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Japan.
Clin Nephrol. 1992 Sep;38(3):149-53.
To evaluate bone loss in renal osteodystrophy, we measured total and regional (head, trunk, pelvis, leg and arm) bone mineral density (BMD) by dual photon absorptiometry in 72 patients on maintenance hemodialysis (HD). We also examined the validity of serum carboxy-terminal parathyroid hormone (C-PTH) and intact-PTH as an indicator of secondary hyperparathyroidism. Total BMD correlated inversely with age in female patients (r = -0.57, p less than 0.01), but not in male patients. Female patients older than 50 years were omitted from analysis to exclude the effect of menopause on bone. Among clinical and biochemical parameters, only trunk BMD correlated inversely with the duration of HD (r = -0.26, p less than 0.05). Head, trunk and total BMD correlated inversely with serum alkaline phosphatase, C-PTH and intact-PTH, while pelvis BMD did not. Leg and arm BMD also correlated inversely with serum intact-PTH, but not with serum C-PTH. The serum level of C-PTH correlated positively with the duration of HD (r = 0.40, p less than 0.005), while intact-PTH did not. As compared with 18 control male volunteers aged 25-42 years, trunk, pelvis, leg, arm and total BMD were significantly lower in male patients on HD aged 22-49 years, whereas head BMD did not differ significantly between the two groups. The percent decrease of BMD was most prominent in the trunk (-19.6%, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
为评估肾性骨营养不良中的骨质流失情况，我们采用双能光子吸收法测量了72例维持性血液透析（HD）患者的全身及局部（头部、躯干、骨盆、腿部和手臂）骨矿物质密度（BMD）。我们还检验了血清羧基末端甲状旁腺激素（C-PTH）和完整甲状旁腺激素（intact-PTH）作为继发性甲状旁腺功能亢进指标的有效性。女性患者的全身BMD与年龄呈负相关（r = -0.57，p < 0.01），而男性患者则不然。为排除绝经对骨骼的影响，分析时排除了年龄超过50岁的女性患者。在临床和生化参数中，只有躯干BMD与HD持续时间呈负相关（r = -0.26，p < 0.05）。头部、躯干和全身BMD与血清碱性磷酸酶、C-PTH和完整PTH呈负相关，而骨盆BMD则不然。腿部和手臂BMD也与血清完整PTH呈负相关，但与血清C-PTH无关。血清C-PTH水平与HD持续时间呈正相关（r = 0.40，p < 0.005），而完整PTH则不然。与18名年龄在25 - 42岁的男性对照志愿者相比，22 - 49岁的HD男性患者的躯干、骨盆、腿部、手臂和全身BMD显著降低，而两组之间的头部BMD无显著差异。BMD下降百分比在躯干最为显著（-19.6%，p < 0.001）。（摘要截选至250字）
