Milinković Neda L, Majkic-Singh Nada T, Ignjatović Svetlana D, Lezaić Visnja D, Pejanović Svetlana D, Jovanovic Dijana B
Center of Medical Biochemistry, Clinical Center of Serbia, Institute of Medical Biochemistry, Pharmaceutical Faculty, University of Belgrade, Serbia.
Clin Lab. 2012;58(7-8):747-53.
Bone alkaline phosphatase (BALP) is a direct and independent indicator of impaired bone turnover. We intended to find out whether there are any significant changes in BALP and iPTH levels, in comparison to total Ca, total Mg, inorganic P, total alkaline phosphatase (ALP), and tartrate resistant acid phosphatase (TRAP) in predialysis and dialysis patients.
Out of 266 patients investigated, 114 were on continuous ambulatory peritoneal dialysis, 112 were on maintenance haemodialysis, while 40 predialysis patients had end stage renal disease. The parameters were analysed according to the manufacturers' instructions.
Correlations were established for the bone marker concentrations analysed among the studied groups. The largest ranges were determined for BALP and iPTH. Predialysis and dialysis patients showed very low levels of BALP. Dialysis patients had lower levels of iPTH (p < 0.001), while in predialysis patients the levels were significantly higher (p < 0.05) than recommended for low bone turnover, according to K/DOQI.
The observations made in this study identify BALP as a good indicator of decreased bone turnover in predialysis and dialysis patients. However, in order to reveal a difference between bone activity and the level of parathyroid activity and its effect on bone turnover, it is always necessary to observe both BALP and iPTH levels.
骨碱性磷酸酶（BALP）是骨转换受损的直接且独立指标。我们旨在探究与透析前及透析患者的总钙、总镁、无机磷、总碱性磷酸酶（ALP）和抗酒石酸酸性磷酸酶（TRAP）相比，BALP和iPTH水平是否有显著变化。
在266例接受调查的患者中，114例接受持续性非卧床腹膜透析，112例接受维持性血液透析，40例透析前患者患有终末期肾病。各项参数均按照制造商的说明进行分析。
在所研究的组间建立了分析的骨标志物浓度之间的相关性。BALP和iPTH的变化范围最大。透析前和透析患者的BALP水平非常低。透析患者的iPTH水平较低（p < 0.001），而根据K/DOQI，透析前患者的iPTH水平显著高于低骨转换推荐水平（p < 0.05）。
本研究中的观察结果表明BALP是透析前和透析患者骨转换降低的良好指标。然而，为了揭示骨活性与甲状旁腺活性水平及其对骨转换的影响之间的差异，始终有必要同时观察BALP和iPTH水平。
