Schmidt H, Stracke H, Schatz H, Scheuermann E H, Fassbinder W, Schoeppe W
Zentrum Innere Medizin Universitäts-Klinik Frankfurt.
Klin Wochenschr. 1989 Mar 1;67(5):297-303. doi: 10.1007/BF01892898.
Osteocalcin serum levels reflect bone turnover. In renal insufficiency secondary hyperparathyroidism and reduced renal clearance might be responsible for elevated serum levels of osteocalcin. Renal transplantation might improve renal osteodystrophy and therefore could influence osteocalcin serum levels. We determined the influence of renal transplantation on osteocalcin levels in 37 consecutive patients (25m/12f) by RIA. Blood samples were collected prior to, 3 days, 28 days, 6 months and 12 months after renal transplantation. Prior to renal transplantation osteocalcin levels were significantly elevated (mean +/- s: 23.4 +/- 12.8 ng/ml) compared to healthy volunteers (4.1 +/- 1.4 ng/ml). Following renal transplantation osteocalcin decreased significantly (9.4 +/- 8.9 ng ml) 3 days and (7.1 +/- 7.8 ng/ml) 28 days. However, 6 and 12 months following renal transplantation the mean osteocalcin level increased again (8.3 +/- 5.7 ng/ml, 12.1 +/- 15.4 ng/ml). At 6 months 11 and at 12 months only 6 of 37 patients had osteocalcin levels in the normal range. 12 months following renal transplantation 21 out of 37 patients with elevated osteocalcin levels had parathyroid hormone levels above the normal range. Additionally to increased osteocalcin levels patients prior to renal transplantation had elevated alkaline phosphatase. Alkaline phosphatase had following renal transplantation a similar pattern as osteocalcin with initial decrease and secondary increase 6 and 12 months after renal transplantation. Parathyroid hormone was elevated in all patients before renal transplantation. Following renal transplantation mean parathyroid hormone levels tell significantly, however remained above normal range in 57% of these 37 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
骨钙素血清水平反映骨转换。在肾功能不全继发甲状旁腺功能亢进中,肾脏清除率降低可能是骨钙素血清水平升高的原因。肾移植可能改善肾性骨营养不良,因此可能影响骨钙素血清水平。我们通过放射免疫分析法测定了37例连续患者(25例男性/12例女性)肾移植对骨钙素水平的影响。在肾移植前、移植后3天、28天、6个月和12个月采集血样。与健康志愿者(4.1±1.4 ng/ml)相比,肾移植前骨钙素水平显著升高(平均值±标准差:23.4±12.8 ng/ml)。肾移植后3天骨钙素显著下降(9.4±8.9 ng/ml),28天(7.1±7.8 ng/ml)。然而,肾移植后6个月和12个月,平均骨钙素水平再次升高(8.3±5.7 ng/ml,12.1±15.4 ng/ml)。6个月时,37例患者中有11例骨钙素水平在正常范围内,12个月时只有6例。肾移植12个月后,37例骨钙素水平升高的患者中有21例甲状旁腺激素水平高于正常范围。肾移植前患者除骨钙素水平升高外,碱性磷酸酶也升高。肾移植后碱性磷酸酶与骨钙素具有相似的模式,移植后6个月和12个月先下降后升高。所有患者肾移植前甲状旁腺激素均升高。肾移植后平均甲状旁腺激素水平显著下降,但这37例患者中有57%仍高于正常范围。(摘要截短于250字)