Celik Ahmet, Davutoglu Vedat, Sarica Kemal, Erturhan Sakip, Ozer Orhan, Sari Ibrahim, Yilmaz Mustafa, Baltaci Yasemin, Akcay Murat, Al Behcet, Yuce Murat, Yilmaz Necat
Department of Cardiology, Gaziantep University, School of Medicine, Gaziantep, Turkey.
Ann Saudi Med. 2010 Jul-Aug;30(4):301-5. doi: 10.4103/0256-4947.65264.
Mitral annular calcification (MAC) is associated with osteoporosis and there is evidence of reduced bone mineral density (BMD) in patients with renal stone formation (RSF). Therefore, we designed this study to test if RSF was associated with MAC and if this association could be linked to bone resorption.
Fifty-nine patients (mean age, 41.5 years) with RSF and 40 healthy subjects (mean age, 44.2 years) underwent screening for MAC and BMD, and measurements were taken of serum and urine electrolytes, parathyroid hormone, alkaline phosphatase and urine dypyridoline.
MAC was diagnosed in 11 (18%) patients with RSF compared with 1 (2.5%) control (P=.01). Urine phosphorus, magnesium, sodium, potassium and chloride levels were lower (P<.001, P=.02, P<.001, P<.001 and P<.001, respectively), but serum alkaline phosphatase, calcium and potassium levels were higher (P=.008, P=.007 and P=.001, respectively) in patients with RSF versus those without RSF. None of these abnormalities were found in patients or subjects with MAC. Urine pyridoline levels were higher and T-scores were more negative (more osteopenic) in patients and subjects with MAC than in those without MAC (P=.01 and P=.004, respectively). In a multivariate analysis, only T-scores and urine dipyridoline level were predictive of MAC (P=.03 and P=.04, respectively).
Screening for MAC and bone resorption markers in patients with RSF demonstrated a high incidence of MAC in these patients. The presence of MAC in patients with RSF was associated with bone resorption markers. This seemingly complex interrelationship between RSF, MAC and bone loss needs to be clarified in further studies.
二尖瓣环钙化（MAC）与骨质疏松相关，且有证据表明肾结石形成（RSF）患者的骨矿物质密度（BMD）降低。因此，我们设计了本研究，以检验RSF是否与MAC相关，以及这种关联是否与骨吸收有关。
59例RSF患者（平均年龄41.5岁）和40名健康受试者（平均年龄44.2岁）接受了MAC和BMD筛查，并检测了血清和尿液电解质、甲状旁腺激素、碱性磷酸酶及尿二吡啶啉。
11例（18%）RSF患者被诊断为MAC，而对照组为1例（2.5%）（P = 0.01）。与无RSF的患者相比，RSF患者的尿磷、镁、钠、钾和氯水平较低（分别为P < 0.001、P = 0.02、P < 0.001、P < 0.001和P < 0.001），但血清碱性磷酸酶、钙和钾水平较高（分别为P = 0.008、P = 0.007和P = 0.001）。MAC患者或受试者未发现这些异常。与无MAC的患者或受试者相比，MAC患者或受试者的尿吡啶啉水平较高，T值更负（骨质减少更明显）（分别为P = 0.01和P = 0.004）。多因素分析显示，只有T值和尿二吡啶啉水平可预测MAC（分别为P = 0.03和P = 0.04）。
对RSF患者进行MAC和骨吸收标志物筛查发现，这些患者中MAC的发生率较高。RSF患者中MAC的存在与骨吸收标志物有关。RSF、MAC和骨质流失之间这种看似复杂的相互关系需要在进一步研究中加以阐明。
