Relationship between Biochemical Markers and Radial Cortical Bone Changes in Hemodialysis Patients
Relationship between Biochemical Markers and Radial Cortical Bone Changes in Hemodialysis Patients
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DOI：
10.1159/000323669
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发表时间：
2011-01-01
影响因子：
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通讯作者：
Fukagawa, Masafumi
中科院分区：
文献类型：
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作者：
Fujimori, Akira;Okada, Shioko;Fukagawa, Masafumi
背景/目的：骨质疏松症患者的骨丢失可以通过骨转换生化标志物的升高来预测。因此，我们研究了慢性血液透析患者的甲状旁腺激素（PTH）等生化标志物与桡骨皮质骨2年变化之间的关系。方法：对 53 名维持性血液透析患者进行抗酒石酸酸性磷酸酶 5b (TRACP-5b)、骨特异性碱性磷酸酶、全 PTH 和总完整 PTH 检测。此外，每隔 2 年通过外周定量计算机断层扫描测量桡骨皮质骨矿物质密度 (BMD) 和相对皮质面积 (RCA)。结果：2 年内，所有患者的 BMD 下降了 2.5%，RCA 下降了 5.8%。在所有女性患者中，TRACP-5b 水平与 RCA 下降显着相关，但与 BMD 下降无关。骨特异性碱性磷酸酶与所有患者的 BMD 下降以及所有女性患者的 RCA 下降相关。整个 PTH 与 RCA 或 BMD 降低无关。总完整 PTH 与所有男性患者的 BMD 降低以及所有女性患者的 RCA 降低显着相关。在逐步多元回归分析中，TRACP-5b 和总完整 PTH 分别被选为 RCA 下降和 BMD 下降的解释变量。结论：这些结果表明 TRACP-5b 和完整 PTH 是预测血液透析患者桡骨皮质骨丢失的有力标志物。版权所有 (C) 2011 S. Karger AG，巴塞尔
Background/Aim: Bone loss in patients with osteoporosis may be predicted by the elevation of biochemical markers of bone turnover. Therefore, we studied the relationship between biochemical markers, including parathyroid hormone (PTH), and the 2-year change in radial cortical bone in patients under chronic hemodialysis. Methods: Tartrate-resistant acid phosphatase-5b (TRACP-5b), bone-specific alkaline phosphatase, whole PTH, and total intact PTH were measured in 53 patients under maintenance hemodialysis. Additionally, radial cortical bone mineral density (BMD) and relative cortical area (RCA) were measured by peripheral quantitative computed tomography 2 years apart. Results: In all patients, BMD decreased by 2.5% and RCA decreased by 5.8% during 2 years. TRACP-5b levels significantly correlated with decreased RCA in all and female patients, but not with decreased BMD. Bone-specific alkaline phosphatase correlated with decreased BMD in all patients and with decreased RCA in all and female patients. Whole PTH did not correlate with decreased RCA or BMD. Total intact PTH significantly correlated with decreased BMD in all and male patients and with decreased RCA in all and female patients. In stepwise multiple regression analysis, TRACP-5b and total intact PTH were selected as explanatory variables for decreased RCA and decreased BMD, respectively. Conclusion: These results suggest that TRACP-5b and total intact PTH are powerful markers to predict radial cortical bone loss in hemodialysis patients. Copyright (C) 2011 S. Karger AG, Basel