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威廉姆斯-贝伦综合征患者的骨矿物质状况与代谢

Bone mineral status and metabolism in patients with Williams-Beuren syndrome.

作者信息

Stagi Stefano, Manoni Cristina, Scalini Perla, Chiarelli Francesco, Verrotti Alberto, Cecchi Cecilia, Lapi Elisabetta, Giglio Sabrina, Romano Silvia, de Martino Maurizio

机构信息

Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, viale Pieraccini 24, Florence, Italy.

Department of Paediatrics, University of Chieti, Chieti, Italy.

出版信息

Hormones (Athens). 2016 Jul;15(3):404-412. doi: 10.14310/horm.2002.1683.

Abstract

OBJECTIVE

To evaluate bone mineral status and metabolism in a cohort of patients with Williams-Beuren syndrome (WBS).

PATIENTS

Thirty-one children (15 females, 16 males; mean age 9.6±2.74 years) and 10 young adults (6 females, 4 males; mean age 21.4±5.11 years) with WBS were cross-sectionally evaluated and compared with two age-, sex-, and body-size-matched paediatric (155 subjects, 75 females and 80 males; mean age 9.7±2.93 years) and adult (50 subjects, 30 females and 20 males; mean age 22.3±5.42 years) healthy controls.

MEASUREMENTS

We evaluated ionised and total calcium, phosphate, parathyroid hormone (PTH), 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, osteocalcin, bone alkaline phosphatase levels, and urinary deoxypyridinoline concentrations. We also calculated the phalangeal amplitude-dependent speed of sound (AD-SoS) and the bone transmission time (BTT) z-scores.

RESULTS

WBS patients showed a significantly reduced AD-SoS z-score (p <0.001) and BTT z-score (p <0.001) compared with the controls. This finding persisted when we divided the sample into paediatric and adult patients. WBS patients also had significantly higher ionised (p <0.001) and total calcium (p <0.001) levels as well as higher PTH levels (p <0.001) compared with the controls. Furthermore, WBS children and adolescents had significantly lower serum osteocalcin levels (p <0.001) and urinary deoxypyridinoline concentrations (p <0.001) than controls.

CONCLUSIONS

WBS subjects exhibit a significant reduction in bone mineral status and impaired bone metabolism. These findings point to the need for close monitoring of WBS patients.

摘要

目的

评估一组威廉斯-贝伦综合征(WBS)患者的骨矿物质状态和代谢情况。

患者

对31名患有WBS的儿童(15名女性,16名男性;平均年龄9.6±2.74岁)和10名年轻成人(6名女性,4名男性;平均年龄21.4±5.11岁)进行横断面评估,并与两组年龄、性别和体型匹配的儿科(155名受试者,75名女性和80名男性;平均年龄9.7±2.93岁)及成人(50名受试者,30名女性和20名男性;平均年龄22.3±5.42岁)健康对照者进行比较。

测量指标

我们评估了离子钙和总钙、磷酸盐、甲状旁腺激素(PTH)、25-羟基维生素D、1,25-二羟基维生素D、骨钙素、骨碱性磷酸酶水平以及尿脱氧吡啶啉浓度。我们还计算了指骨振幅依赖性声速(AD-SoS)和骨传导时间(BTT)的z评分。

结果

与对照组相比,WBS患者的AD-SoS z评分(p<0.001)和BTT z评分(p<0.001)显著降低。当我们将样本分为儿科和成人患者时,这一发现仍然存在。与对照组相比,WBS患者的离子钙(p<0.001)和总钙水平(p<0.001)以及PTH水平也显著更高(p<0.001)。此外,WBS儿童和青少年的血清骨钙素水平(p<0.001)和尿脱氧吡啶啉浓度(p<0.001)显著低于对照组。

结论

WBS患者的骨矿物质状态显著降低,骨代谢受损。这些发现表明需要对WBS患者进行密切监测。

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