EFFECT OF RENAL-FUNCTION ON PLASMA-LEVELS OF BONE GLA-PROTEIN
EFFECT OF RENAL-FUNCTION ON PLASMA-LEVELS OF BONE GLA-PROTEIN
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DOI：
10.1210/jcem-57-5-1028
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发表时间：
1983-01-01
影响因子：
5.8
通讯作者：
RIGGS, BL
中科院分区：
文献类型：
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作者：
DELMAS, PD;WILSON, DM;RIGGS, BL
血浆骨γ-骨钙素（osteocalcin，BGP）是代谢性骨病的敏感、特异的标志物。由于BGP主要通过肾脏清除从循环中清除，因此肾功能受损受试者血浆BGP升高可能是由于肾脏清除率降低、牛代谢增加或两者兼而有之。这些因素在62例不同程度肾衰竭患者中进行了评估，其中血浆BGP，[125 I]碘酞酸清除率[肾小球滤过率（GFR）的测量]和[131 I] o-碘马尿酸清除率（有效肾血浆流量的测量）进行了测量。在GFR大于30 ml/min的所有患者中。1.73 m2时，血浆BGP在年龄和性别相当的对照受试者的正常范围内，并且直到GFR低于20 ml/min时才发生血浆BGP的大幅增加。1.73 M2.非线性回归分析表明，血浆BGP的变化基本上可以用GFR的指数来解释。类似地，对于有效肾血浆流量值高于150 ml/min，血浆BGP是正常的。1.73 M2.因此，对于正常受试者和轻度至中度肾衰竭患者，血浆BGP升高反映了骨转换增加，而不是肾滤过率降低。
Plasma bone .gamma.-carboxyglutamic acid-protein (osteocalcin, BGP) is a sensitive and specific marker for metabolic bone disease. Because BGP is removed from the circulation mainly by kidney clearance, increased plasma BGP in subjects with impaired renal function could be due to decreased renal clearance, increased bovine metabolism, or both. These factors were evaluated in 62 patients with various degrees of renal failure in whom plasma BGP, [125I]iothalamate clearance [a measure of glomerular filtration rate (GFR)], and [131I]o-iodohippurate clearance (a measure of effective renal plasma flow) were measured. In all patients with GFR greater than 30 ml/min .cntdot. 1.73 m2, plasma BGP was within the normal range for age- and sex-comparable control subjects, and large increases in plasma BGP did not occur until GFR was below 20 ml/min .cntdot. 1.73 m2. Nonlinear regression analysis showed that the variation in plasma BGP was substantially accounted for using the exponential of GFR. Similarly, plasma BGP was normal for values of effective renal plasma flow above 150 ml/min .cntdot. 1.73 m2. Thus, for normal subjects and patients with mild to moderate renal failure, plasma elevations of BGP reflect increased bone turnover rather than decreased renal filtration.