Bayat N, Einollahi B, Pourfarzian V, Alishiri G, Nemati E, Bagheri N, Miri S M, Elizeii P K
Rheumatology Department, Baqyiatollah University, Tehran, Iran.
Transplant Proc. 2007 May;39(4):1039-43. doi: 10.1016/j.transproceed.2007.03.083.
We studied bone mineral density (BMD) changes in Iranian patients with end-stage renal disease (ESRD) within 11 months after renal transplantation.
Among 68 ESRD candidates for renal transplantation, the BMD at the femur and the spine were assessed using a DEXA Norland scanner. Linear regression analysis was used to identify risk factors associated with low bone density.
Mean BMD, T-score and Z-score of femur and spine were significantly reduced (at femur, 0.78 +/- 0.14, -2.4 +/- 1.1, -1.6 +/- 1.0; at spine, 142.25 +/- 105, -1.09 +/- 1.1, -1.07 +/- 0.9). Osteoporosis and osteopenia were found 55.2% and 36.2% at the femur and 8.6% and 58.6% at the spine, respectively. The BMD showed a significant negative association with age (r=0.615), female gender (r=0.394), and corticosteroid intake (r=0.286), and a positive association with weight (r=0.394) and body mass index (r=0.626). There was no significant association between BMD measurements and calcium, phosphorous, or parathyroid hormone levels. At 11 months follow-up, in 20 patients, the subject had lost a mean of 2.4% T-score and 2.8% Z-score at spine (P=.027 and .13, respectively), but did not experience significant declines at the femur. BMD showed a decrease in 80% of recipients in the spine area; there was a 15% BMD increase at the hip.
Low bone density is common among ESRD Iranian patients. Early screening and treatment of this group is recommended. Significant loss in lumbar density occurred within 11 months of transplantation in more than one third of a prospective cohort of renal transplant recipients.
我们研究了伊朗终末期肾病（ESRD）患者肾移植后11个月内的骨密度（BMD）变化。
在68例等待肾移植的ESRD患者中，使用双能X线吸收法（DEXA）诺兰德扫描仪评估股骨和脊柱的骨密度。采用线性回归分析确定与低骨密度相关的危险因素。
股骨和脊柱的平均骨密度、T值和Z值均显著降低（股骨：0.78±0.14，-2.4±1.1，-1.6±1.0；脊柱：142.25±105，-1.09±1.1，-1.07±0.9）。股骨骨质疏松和骨量减少的发生率分别为55.2%和36.2%，脊柱分别为8.6%和58.6%。骨密度与年龄（r=0.615）、女性性别（r=0.394）和皮质类固醇摄入量（r=0.286）呈显著负相关，与体重（r=0.394）和体重指数（r=0.626）呈正相关。骨密度测量值与钙、磷或甲状旁腺激素水平之间无显著关联。在11个月的随访中，20例患者脊柱的T值平均降低了2.4%，Z值平均降低了2.8%（P分别为0.027和0.13），但股骨未出现显著下降。80%的受者脊柱骨密度降低；髋部骨密度增加了15%。
低骨密度在伊朗ESRD患者中很常见。建议对该群体进行早期筛查和治疗。在一个前瞻性肾移植受者队列中，超过三分之一的患者在移植后11个月内腰椎密度出现显著下降。
