Section of Nephrology, Department of Medicine, Rikshospitalet, Oslo, Norway.
Clin Transplant. 2010 Sep-Oct;24(5):E145-52. doi: 10.1111/j.1399-0012.2010.01231.x.
Post-transplant bone disease is common in solid organ recipients; however, there is limited information on their pre-transplant bone status. We aimed to compare bone mineral density (BMD) in different categories of patients with end-stage organ failure awaiting transplantation (Tx) in Norway. Overall 291 adult patients were enrolled, including 60, 84, 81 and 66 patients with end-stage lung, liver, kidney and heart failure, respectively. Mean age was 51 ± 12 yr with no significant differences between the groups. We measured BMD in lumbar spine, femur, proximal one third and ultra-distal radius by dual energy X-ray absorptiometry. Differences in T- and Z-scores between the groups were compared by ANOVA. Low bone mass was found in all four groups of patients. Both T- and Z-scores differed (p < 0.05) at all measured sites between the groups. Patients with lung failure had the highest prevalence of osteoporosis (67%) and lowest Z-scores, followed by patients with liver (31%), kidney (24%), and heart (23%) failure. Osteoporosis is prevalent in all groups of organ transplant candidates, and poor bone health is remarkably pronounced in patients with chronic lung disease. General practitioners and specialists who care for these patients before they are referred for transplantation should consider measures to prevent osteoporosis at an earlier stage.
移植后骨骼疾病在实体器官受者中很常见；然而，关于其移植前骨骼状况的信息有限。我们旨在比较挪威等待移植（Tx）的终末期器官衰竭患者不同类别中的骨矿物质密度（BMD）。共有 291 名成年患者入组，包括终末期肺、肝、肾和心力衰竭患者各 60、84、81 和 66 例。平均年龄为 51 ± 12 岁，各组间无显著差异。我们通过双能 X 射线吸收法测量了腰椎、股骨、近端三分之一和超远端桡骨的 BMD。通过方差分析比较了组间 T 值和 Z 值的差异。所有四组患者均存在低骨量。T 值和 Z 值在所有测量部位均存在差异（p < 0.05）。肺衰竭患者的骨质疏松症患病率最高（67%），Z 值最低，其次是肝衰竭患者（31%）、肾衰竭患者（24%）和心力衰竭患者（23%）。骨质疏松症在所有器官移植候选人群中都很普遍，慢性肺部疾病患者的骨健康状况明显较差。在这些患者被转介接受移植之前，照顾他们的全科医生和专科医生应考虑采取措施更早地预防骨质疏松症。
