Brzęczek Maciej, Hyla-Klekot Lidia, Kokot Franciszek, Synder Marek
Oddział Chirurgii Urazowo-Ortopedycznej, Zespół Opieki Zdrowotnej w Oleśnie, Polska / Department of Trauma and Orthopaedic Surgery, Health Care Facility in Olesno, Poland.
Klinika Chirurgii i Urologii Dziecięcej, Śląski Uniwersytet Medyczny w Katowicach, Polska / Department of Paediatric Surgery and Urology, Medical University of Silesia in Katowice, Poland.
Ortop Traumatol Rehabil. 2019 Aug 31;21(4):271-278. doi: 10.5604/01.3001.0013.5072.
The multifactor aetiology of adolescent idiopathic scoliosis is commonly acknowledged. Both multivariate analyses of large study groups and the search for causes of adolescent idiopathic scoliosis and its progression in individual patients indicate that the aetiopathogenesis of this disorder is remarkably complex. The discovery of novel bone turnover markers, such as Klotho protein and FGF-23, means that their role in this condition also has to be considered. The aim of this paper is to evaluate the FGF-23 and Klotho protein concentration profiles as new contributors to the regulation of calcium and phosphate metabolism in children with adolescent idiopathic scoliosis and compare them with the values seen in healthy children.
The study assessed a total of 70 children, including 35 children treated at the postural defects clinic of the Health Care Facility in Oleśno following a diagnosis of adolescent idiopathic scoliosis and 35 healthy children who constituted a control group. The levels of classic bone turnover markers, such as calcium and phosphorus concentration, alkaline phosphatase, 25-OH-D, and parathyroid hormone (PTH) activity, and of newly discovered contributors to calcium and phosphate metabolism regulation, namely Klotho protein and FGF-23, were determined in both groups.
There were statistically significant differences in the levels of basic parameters of calcium and phosphate metabolism between children with scoliosis and the control group, with scoliotic patients showing elevated calcium and 25-OH-D levels and reduced parathyroid hormone levels. Klotho protein levels in children with scoliosis were significantly lower than in the control group. Moreover, the scoliotic patients showed a marked trend towards higher FGF-23 levels as compared to the control group.
青少年特发性脊柱侧凸的多因素病因已得到普遍认可。对大型研究组的多变量分析以及对青少年特发性脊柱侧凸病因及其在个体患者中进展情况的研究均表明，该疾病的病因发病机制极为复杂。新型骨转换标志物（如 Klotho 蛋白和 FGF - 23）的发现意味着它们在这种疾病中的作用也必须加以考虑。本文旨在评估 FGF - 23 和 Klotho 蛋白浓度谱作为青少年特发性脊柱侧凸患儿钙磷代谢调节新因素的作用，并将其与健康儿童的相关值进行比较。
该研究共评估了 70 名儿童，其中包括 35 名在奥莱希诺医疗保健机构姿势缺陷诊所被诊断为青少年特发性脊柱侧凸后接受治疗的儿童，以及 35 名构成对照组的健康儿童。两组均测定了经典骨转换标志物的水平，如钙和磷浓度、碱性磷酸酶、25 - OH - D 以及甲状旁腺激素（PTH）活性，还测定了新发现的钙磷代谢调节因素，即 Klotho 蛋白和 FGF - 23。
脊柱侧凸患儿与对照组之间钙磷代谢基本参数水平存在统计学显著差异，脊柱侧凸患者的钙和 25 - OH - D 水平升高，甲状旁腺激素水平降低。脊柱侧凸患儿的 Klotho 蛋白水平显著低于对照组。此外，与对照组相比，脊柱侧凸患者的 FGF - 23 水平有明显升高趋势。
