Polak-Jonkisz Dorota, Zwolińska Danuta, Nahaczewska Wiesława
Katedra i Klinika Nefrologii Pediatrycznej Akademii Medycznej we Wroclawiu.
Pediatr Endocrinol Diabetes Metab. 2010;16(1):25-8.
Chronic kidney disease (CKD) leads to bone and mineral complications, which are manifested, among others, by hyperparathyroidism, calcium-phosphate and vitamin D balance disturbances. The results of investigation assessing the usefulness of CAP/CIP ratio, (cyclase activating PTH/cyclase inactive PTH) as a marker of bone turnover and bone disturbances in this group of patients are contradictory.
was to estimate the concentration of CAP and CIP of parathormone, connection with selected calcium-phosphate balance parameters and usefulness of CAP/CIP ratio to differentiate bone mineral density in patients with CKD treated with repeated haemodialysis.
The study included 31 children aged 5 to 18 years. Group I - 15 haemodialysed children. Group II - 16 healthy children. The patients underwent the following serum measurements: calcium concentration (Ca), inorganic phosphate (P), 1.25-dihydroxyvitamin D, parathormone (intact PTH), and CAP, CIP were evaluated with Scantibodies Laboratory Inc test. In group I the densitometric examination was done using the Lunar DPX-L system, performing the overall bone measurement.
In children from group I the average values of iPTH concentration and both CIP and CAP components were significantly elevated (p<0.05) as compared to group II. CAP/CIP ratio in group I was <1; in healthy children >1. Average concentrations of Ca and 1.25(OH)2D in serum of group I were lowered, although without statistical significance in comparison with group II. CAP/CIP ratio does not differentiate the children with bone disturbances. Densitometric examination revealed osteopenic changes in 3 children and osteoporosis in 2 children. There were no statistically significant correlations between the examined parameters.
慢性肾脏病（CKD）会导致骨与矿物质并发症，其中表现为甲状旁腺功能亢进、钙磷及维生素D平衡紊乱。评估环化酶激活型甲状旁腺激素/环化酶失活型甲状旁腺激素（CAP/CIP）比值作为该组患者骨转换和骨紊乱标志物的研究结果相互矛盾。
旨在评估甲状旁腺激素的CAP和CIP浓度，与选定的钙磷平衡参数的关系，以及CAP/CIP比值在接受重复血液透析治疗的CKD患者中区分骨密度的效用。
该研究纳入了31名5至18岁的儿童。第一组 - 15名接受血液透析的儿童。第二组 - 16名健康儿童。患者接受了以下血清检测：钙浓度（Ca）、无机磷（P）、1,25 - 二羟维生素D、甲状旁腺激素（完整PTH），并使用Scantibodies Laboratory Inc检测评估CAP和CIP。在第一组中，使用Lunar DPX - L系统进行骨密度检查，进行全身骨测量。
与第二组相比，第一组儿童的iPTH浓度以及CIP和CAP成分的平均值均显著升高（p<0.05）。第一组的CAP/CIP比值<1；健康儿童>1。第一组血清中Ca和1,25(OH)2D的平均浓度降低，尽管与第二组相比无统计学意义。CAP/CIP比值无法区分有骨紊乱的儿童。骨密度检查显示3名儿童有骨质减少变化，2名儿童有骨质疏松。所检测参数之间无统计学显著相关性。
