造血细胞移植患者的维生素D、甲状旁腺激素水平及骨密度

[Vitamin D and parathyroid hormone levels and bone mineral density in patients undergoing hematopoietic cell transplantation].

作者信息

Florenzano Pablo, Ernst Daniel, Lustig Nicole, Rojas Patricio, Ramírez Pablo, Campusano Claudia

机构信息

Departamento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,

Departamento de Hemato-Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Rev Med Chil. 2016 Sep;144(9):1119-1124. doi: 10.4067/S0034-98872016000900004.

DOI:10.4067/S0034-98872016000900004

PMID:28060972

Abstract

BACKGROUND

Patients undergoing hematopoietic cell transplantation (HCT) are at increased risk of developing osteoporosis.

AIM

To determine the frequency and severity of Vitamin D deficiency, secondary hyperparathyroidism and low bone mass in patients undergoing HCT.

PATIENTS AND METHODS

Analysis of the database of patients undergoing HCT in our institution in the 2010-2015 period. We searched for patients with measurements of 25-OH vitamin D (25OHD), parathyroid hormone (PTH) and bone densitometry by double beam X ray absorptiometry (DXA) prior and up to one year after HCT.

RESULTS

Ninety patients were included, 53 were evaluated prior to HCT and 37 after HCT. They represent 73% of all patients undergoing HCT in the period. Median 25OHD was 12 ng/ml (range 4-41.4). Ninety seven percent of patients had levels considered insufficient and 85% compatible with deficiency. Median PTH was 60.5 pg/ml (range 21-186). Forty five percent of patients had secondary hyperparathyroidism. DXA was performed in 65 patients (prior to HCT in 54 and after HCT in 11). Of these, 11% had had a low bone mineral density.

CONCLUSIONS

Patients undergoing HCT have a high risk of vitamin D deficiency, secondary hyperparathyroidism and low bone mineral density.

摘要

背景

接受造血细胞移植（HCT）的患者发生骨质疏松的风险增加。

目的

确定接受HCT的患者维生素D缺乏、继发性甲状旁腺功能亢进和低骨量的发生率及严重程度。

患者与方法

分析我院2010 - 2015年期间接受HCT患者的数据库。我们查找了在HCT前及HCT后长达一年期间进行25 - 羟基维生素D（25OHD）、甲状旁腺激素（PTH）测定以及采用双能X线吸收法（DXA）进行骨密度测量的患者。

结果

纳入90例患者，其中53例在HCT前接受评估，37例在HCT后接受评估。他们占该期间所有接受HCT患者的73%。25OHD中位数为12 ng/ml（范围4 - 41.4）。97%的患者维生素D水平被认为不足，85%符合缺乏标准。PTH中位数为60.5 pg/ml（范围21 - 186）。45%的患者有继发性甲状旁腺功能亢进。65例患者进行了DXA检查（54例在HCT前，11例在HCT后）。其中，11%的患者骨密度低。