青少年特发性脊柱侧凸患者钙磷平衡、维生素D、甲状旁腺激素和降钙素的关联
Association of Calcium and Phosphate Balance, Vitamin D, PTH, and Calcitonin in Patients With Adolescent Idiopathic Scoliosis.
作者信息
Goździalska Anna, Jaśkiewicz Jerzy, Knapik-Czajka Małgorzata, Drąg Jagoda, Gawlik Maciej, Cieśla Maciej, Kulis Aleksandra, Zarzycki Daniel, Lipik Ewa
机构信息
*Faculty of Health and Medical Science, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland†Department of Analytical Biochemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland‡Department of Toxicology, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland§Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland¶Department of Occupational Therapy, University School of Physical Education, Krakow, Poland||Department of Orthopaedics and Rehabilitation, Jagiellonian University, University Hospital of Orthopaedics and Rehabilitation, Zakopane, Poland.
出版信息
Spine (Phila Pa 1976). 2016 Apr;41(8):693-7. doi: 10.1097/BRS.0000000000001286.
STUDY DESIGN
A cross-sectional study of 2 groups of patients with scoliosis, and an age-matched control group was conducted. Each of the groups such as patients with adolescent idiopathic scoliosis (AIS) as well as control group were divided additionally into 2 groups: premenarcheal and postmenarcheal girls.
OBJECTIVE
The aim of the study was to determine the levels of 25-OH-vitamin D3, calcium and phosphate, parathyroid hormone (PTH), and calcitonin in serum of pre- and postmenarcheal girls with AIS and corresponding groups of scoliosis-free controls.
SUMMARY OF BACKGROUND DATA
The primary etiology and pathogenesis of AIS remains unknown. It is assumed that vitamin D deficiency and genetic predisposition, for example, polymorphisms of vitamin D receptor, have a great significance. Vitamin D plays a key role in skeletal development and prevents bone atrophy, affects the absorption of calcium, maintains calcium-phosphate homeostasis, and the bone matrix mineralization. Its deficiency can result in a wide variety of skeletal deformities, low bone mass, and then leads to the disappearance of bone. Defects in trabecular bone structure and/or bone mineralization are the main features of scoliosis. Some studies have reported that Vitamin D deficiency is common among patients with AIS. The mechanism of Vitamin D action on scoliosis development is still unclear.
METHODS
Determination of serum 25-OH-D3 levels was performed using high-performance liquid chromatography chromatography; concentrations of calcium and phosphate were measured using colorimetric methods, and concentration of PTH and calcitonin was measured using ELISA system.
RESULTS
Reduction in the serum levels of 25-OH-D3 and calcitonin in girls with AIS compared with healthy girls was demonstrated.
CONCLUSION
The phosphate-calcium balance and PTH level seem to be normal in patients with AIS. The calcitonin level in girls with AIS is 2-fold lower than in healthy subjects. It is possible that the deficiency of vitamin D can be involved in AIS.
LEVEL OF EVIDENCE
研究设计
对两组脊柱侧弯患者以及一组年龄匹配的对照组进行了横断面研究。青少年特发性脊柱侧弯（AIS）患者组和对照组又各自分为两组：月经初潮前女孩和月经初潮后女孩。
目的
本研究旨在测定月经初潮前和初潮后的AIS女孩血清中25-羟基维生素D3、钙、磷、甲状旁腺激素（PTH）和降钙素的水平，以及相应的无脊柱侧弯对照组的水平。
背景数据总结
AIS的主要病因和发病机制尚不清楚。据推测，维生素D缺乏和遗传易感性，例如维生素D受体的多态性，具有重要意义。维生素D在骨骼发育中起关键作用，可防止骨质萎缩，影响钙的吸收，维持钙磷稳态以及骨基质矿化。其缺乏可导致多种骨骼畸形、低骨量，进而导致骨质流失。小梁骨结构和/或骨矿化缺陷是脊柱侧弯的主要特征。一些研究报告称，AIS患者中维生素D缺乏很常见。维生素D对脊柱侧弯发展的作用机制仍不清楚。
方法
采用高效液相色谱法测定血清25-OH-D3水平；采用比色法测量钙和磷的浓度，采用酶联免疫吸附测定（ELISA）系统测量PTH和降钙素的浓度。
结果
与健康女孩相比，AIS女孩血清中25-OH-D3和降钙素水平降低。
结论
AIS患者的钙磷平衡和PTH水平似乎正常。AIS女孩的降钙素水平比健康受试者低两倍。维生素D缺乏可能与AIS有关。
证据级别
4级。
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