Urology Department, San Cecilio University Hospital, Granada, Spain.
BJU Int. 2011 Dec;108(11):1903-8; discussion 1908. doi: 10.1111/j.1464-410X.2011.10167.x. Epub 2011 May 9.
What's known on the subject? and What does the study add? Hypercalciuria is related with bone mineral density loss. This study demonstrates the relationship between recurrent calcium nephrolithiasis and bone mineral density loss and their correlation with bone markers.
• To show that a relationship exists between the loss of bone mineral density (BMD) and calcium renal lithiasis and that bone remodelling markers correlate with changes in BMD. • It is possible that many cases hypercalciuria are related to the increase of bone turnover and the predominance of bone resorption phenomena.
• The present study comprised a transversal investigation in three groups: group O, without lithiasis; group A, with a single episode of lithiasis; and group B, with relapsed calcium renal lithiasis. • An analysis was made of body mass index; abdominal X-ray and/or urography and renal ultrasonography; osteocalcin and β-crosslaps bone markers; calcium and citrate concentrations in the urine; and femur and spinal column bone densitometry. • The results were analyzed by analysis of variance and Pearson's correlation coefficient.
• Patients with relapsed calcium renal lithiasis present a greater BMD loss than those in the O or A groups. • Densitometry: T-score femur -0.2 group O, -0.5 group A, -1.2 group B (P= 0.001); T-score column -0.6 group O, -0.6 group A, -1.3 group B (P= 0.05). • A statistically significant negative correlation exists between values of β-crosslaps and T-score femur (R=-0.251; P= 0.009) and T-score column (R=-0.324; P= 0.001); thus, a higher concentration of β-crosslaps was accompanied by a lower value of the T-score and a greater loss of BMD. • A positive relationship is observed between β-crosslaps and osteocalcin (R= 0.611; P < 0.001) and between calciuria and cocient β-crosslaps/osteocalcin (R= 0.303; P= 0.001).
• A statistically significant relationship is shown between the loss of BMD and relapsed calcium renal lithiasis. • Determination of bone remodelling markers (i.e. osteocalcin and β-crosslaps) facilitates the diagnosis of osteopaenia/osteoporosis in these patients.
• 证明骨密度（BMD）丢失与钙肾结石之间存在关系，并且骨重塑标志物与 BMD 变化相关。• 可能许多高钙尿症病例与骨转换增加和骨吸收现象为主有关。
• 本研究包括三组的横断面调查：O 组无结石；A 组有单次结石发作；B 组有复发性钙肾结石。• 分析了体重指数；腹部 X 线和/或尿路造影和肾脏超声；骨钙素和β-交联胶原（β-crosslaps）骨标志物；尿钙和柠檬酸盐浓度；以及股骨和脊柱骨密度。• 通过方差分析和 Pearson 相关系数对结果进行分析。
• 复发性钙肾结石患者的 BMD 丢失大于 O 组或 A 组。• 骨密度仪：股骨 T 评分 O 组-0.2，A 组-0.5，B 组-1.2（P=0.001）；脊柱 T 评分 O 组-0.6，A 组-0.6，B 组-1.3（P=0.05）。• β-crosslaps 值与股骨 T 评分（R=-0.251；P=0.009）和脊柱 T 评分（R=-0.324；P=0.001）之间存在显著负相关；因此，β-crosslaps 浓度越高，T 评分越低，BMD 丢失越大。• β-crosslaps 与骨钙素之间存在正相关（R=0.611；P <0.001），钙尿与β-crosslaps/骨钙素比值之间存在正相关（R=0.303；P=0.001）。
• BMD 丢失与复发性钙肾结石之间存在显著关系。• 测定骨重塑标志物（即骨钙素和β-crosslaps）有助于诊断这些患者的骨质疏松症。
