Street Maria E, Spaggiari Cinzia, Ziveri Maria A, Volta Cecilia, Federico Giovanni, Baroncelli Giampiero I, Bernasconi Sergio, Saggese Giuseppe
Department of Pediatrics, University of Parma, Parma, Italy.
Horm Res. 2006;66(4):162-8. doi: 10.1159/000094143. Epub 2006 Jun 23.
Cystic fibrosis (CF) patients present an increased risk of osteoporosis, and increased fracture rate. Several factors have been identified as modulators of bone metabolism and bone mineral density (BMD).
To evaluate BMD and serum markers of bone turnover and establish their relationships with serum concentrations of interleukin (IL)-1beta, IL-6, tumour necrosis factor (TNF)-alpha, IGF-I, IGF-II, IGF binding protein (IGFBP)-2, IGFBP-3, and parathyroid hormone (PTH) in young adult CF patients.
Seventeen young adult CF patients (4 M, 13 F; mean age: 26.6 +/- 1.1 years) were enrolled in the study and analysed as a whole and as two subgroups according to the Shwachman-Kulczycki score. BMD was assessed at the lumbar spine (L1-L4) by dual energy X-ray absorptiometry (DXA Hologic QDR 2000). Bone turnover was assessed by measuring serum levels of osteocalcin (OC) and serum carboxyterminal propeptide of type I collagen (PICP) as markers of bone formation, and serum cross-linked carboxyterminal telopeptide of type I collagen (ICTP) as a marker of bone resorption. Serum IGFs, IGFBPs, and cytokines were assayed using special commercial kits. Daily calcium intake and weekly physical activity were estimated by questionnaires. Forced expiratory volume in one second was used to assess pulmonary function.
Lumbar BMD was normal, although there was a tendency to be lower in the patients with a lower clinical score. Both OC and PICP were increased, whereas ICTP was normal. Lumbar BMD was positively correlated with pulmonary function. IL-6 and C-reactive protein (markers of inflammation) were inversely correlated with PICP. Serum ICTP levels were correlated with serum IGF-I levels. No significant relationship was detected among lumbar BMD, markers of bone turnover and PTH, IGF-I, IGF-II, IGFBP-2, IGFBP-3, TNF-alpha, IL-1beta, and body mass index Z-score.
Bone turnover is abnormal in CF patients. Young adult CF patients with satisfying clinical status and nutritional conditions have normal BMD and increased serum OC and PICP levels.
囊性纤维化（CF）患者骨质疏松风险增加，骨折率也升高。已确定多种因素可调节骨代谢和骨密度（BMD）。
评估年轻成年CF患者的骨密度及骨转换血清标志物，并确定它们与白细胞介素（IL）-1β、IL-6、肿瘤坏死因子（TNF）-α、胰岛素样生长因子（IGF）-I、IGF-II、IGF结合蛋白（IGFBP）-2、IGFBP-3及甲状旁腺激素（PTH）血清浓度之间的关系。
17例年轻成年CF患者（4例男性，13例女性；平均年龄：26.6±1.1岁）纳入本研究，并根据舒瓦克曼-库尔奇茨基评分作为一个整体及两个亚组进行分析。采用双能X线吸收法（DXA Hologic QDR 2000）在腰椎（L1-L4）评估骨密度。通过测量血清骨钙素（OC）水平及血清I型胶原羧基末端前肽（PICP）作为骨形成标志物，以及血清I型胶原交联羧基末端肽（ICTP）作为骨吸收标志物来评估骨转换。使用特殊商业试剂盒检测血清IGF、IGFBP及细胞因子。通过问卷调查估计每日钙摄入量和每周体育活动量。用一秒用力呼气量评估肺功能。
腰椎骨密度正常，尽管临床评分较低的患者有骨密度降低的趋势。OC和PICP均升高，而ICTP正常。腰椎骨密度与肺功能呈正相关。IL-6和C反应蛋白（炎症标志物）与PICP呈负相关。血清ICTP水平与血清IGF-I水平相关。在腰椎骨密度、骨转换标志物与PTH、IGF-I、IGF-II、IGFBP-2、IGFBP-3、TNF-α、IL-1β及体重指数Z评分之间未检测到显著关系。
CF患者骨转换异常。临床状态和营养状况良好的年轻成年CF患者骨密度正常，血清OC和PICP水平升高。
