Yamada Shinsuke, Inaba Masaaki, Kurajoh Masafumi, Shidara Kaori, Imanishi Yasuo, Ishimura Eiji, Nishizawa Yoshiki
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
Clin Endocrinol (Oxf). 2008 Aug;69(2):189-96. doi: 10.1111/j.1365-2265.2008.03187.x. Epub 2008 Jan 23.
Serum tartrate-resistant acid phosphatase (TRACP) 5b levels were assessed in predialysis patients with chronic kidney disease (CKD). The aim of the study was to establish the usefulness of a new assay for TRACP5b in assessing bone turnover in these patients.
Serum concentrations of two bone resorption markers, TRACP5b and N-terminal cross-linking telopeptide of type I collagen (NTX); two bone formation markers, bone specific alkaline phosphatase (bone ALP) and intact osteocalcin (OC[1-49]); and PTH were measured in 98 predialysis CKD patients.
Log serum TRACP5b and other bone markers were significantly negatively correlated with glomerular filtration rate (GFR) and positively correlated with log serum PTH, suggesting an increase in serum bone markers with development of secondary hyperparathyroidism. Multiple regression analysis including age, gender, BMI, the presence of diabetes, GFR and log serum PTH showed an association of log serum PTH with log serum TRACP5b and other bone markers. GFR was associated with log serum NTX and log OC[1-49], but not with log serum TRACP5b or log bone ALP. These data show that renal dysfunction does not influence serum TRACP5b and bone ALP, but has an influence on NTX and OC[1-49].
Serum TRACP5b may be a good marker for serum bone resorption in predialysis CKD patients, as it is not affected by renal dysfunction.
在慢性肾脏病(CKD)的透析前患者中评估了血清抗酒石酸酸性磷酸酶(TRACP)5b水平。本研究的目的是确定一种新的TRACP5b检测方法在评估这些患者骨转换方面的实用性。
测定了98例透析前CKD患者的两种骨吸收标志物TRACP5b和I型胶原N端交联肽(NTX)、两种骨形成标志物骨特异性碱性磷酸酶(骨ALP)和完整骨钙素(OC[1-49])以及甲状旁腺激素(PTH)的血清浓度。
血清TRACP5b对数和其他骨标志物与肾小球滤过率(GFR)显著负相关,与血清PTH对数正相关,提示随着继发性甲状旁腺功能亢进的发展血清骨标志物升高。包括年龄、性别、体重指数、糖尿病的存在、GFR和血清PTH对数的多元回归分析显示血清PTH对数与血清TRACP5b对数和其他骨标志物相关。GFR与血清NTX对数和OC[1-49]对数相关,但与血清TRACP5b对数或骨ALP对数无关。这些数据表明肾功能不全不影响血清TRACP5b和骨ALP,但对NTX和OC[1-49]有影响。
血清TRACP5b可能是透析前CKD患者血清骨吸收的良好标志物,因为它不受肾功能不全的影响。