中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2010年
8期
594-597
,共4页
王玲%袁伟杰%谷立杰%尚明花
王玲%袁偉傑%穀立傑%尚明花
왕령%원위걸%곡립걸%상명화
肾病综合征%骨代谢%骨密度%胰岛素样生长因子-1
腎病綜閤徵%骨代謝%骨密度%胰島素樣生長因子-1
신병종합정%골대사%골밀도%이도소양생장인자-1
Nephrotie syndrome%Bone metabolism%Bone mineral density%Insulin-like growth factor 1
目的 探讨原发性肾病综合征(PNS)患者血清胰岛素样生长因子1(IGF-1)的变化及其与骨代谢指标之间的关系.评价IGF-1在PNS患者骨代谢异常机制中的临床价值.方法 随机选取2008年1月至2009年5月临床资料完整的慢性肾脏病(CKD)1、2期PNS患者30例为对象;健康体检者61例为健康对照组.测定血清IGF-1、钙、磷、PTH、25羟基维生素D3[25-(OH)D3]骨钙素(BGP)、Ⅰ型胶原吡啶交联C终端肽(CTx)及尿钙/尿肌酐(Uca/Cr).双能X线骨密度仪枪测患者骨密度(BMD). 结果与健康埘照组比较,PNS组血Ca、25-(OH)D3及BGP水平显著降低;血CTx水平及Uca/Cr比值显著增高(均P<0.05);BMD水平降低[(1.078±0.090)g/cm2比(1.090±0.062)g/cm2,P>0.05],但差异无统计学意义.PNS组血清IGF-1水平显著低于健康对照组,差异有统计学意义[(155.75±17.48)μg/L比(223.17±16.44)μ/L,P<0.051,且与24 h尿蛋门量及CTx呈负相关(r=-0.757和r=-0.786,均P<0.05);与血BGP和BMD呈正相关(r=0.861和r=0.584,均P<0.05).结论 PNS患者(CKD 1、2期)存在骨代谢异常,表现为骨形成减少、骨吸收增加.血清IGF-1与血BGP、CTx及BMD相关,可作为反映PNS患者骨代谢改变的临床指标之一.
目的 探討原髮性腎病綜閤徵(PNS)患者血清胰島素樣生長因子1(IGF-1)的變化及其與骨代謝指標之間的關繫.評價IGF-1在PNS患者骨代謝異常機製中的臨床價值.方法 隨機選取2008年1月至2009年5月臨床資料完整的慢性腎髒病(CKD)1、2期PNS患者30例為對象;健康體檢者61例為健康對照組.測定血清IGF-1、鈣、燐、PTH、25羥基維生素D3[25-(OH)D3]骨鈣素(BGP)、Ⅰ型膠原吡啶交聯C終耑肽(CTx)及尿鈣/尿肌酐(Uca/Cr).雙能X線骨密度儀鎗測患者骨密度(BMD). 結果與健康塒照組比較,PNS組血Ca、25-(OH)D3及BGP水平顯著降低;血CTx水平及Uca/Cr比值顯著增高(均P<0.05);BMD水平降低[(1.078±0.090)g/cm2比(1.090±0.062)g/cm2,P>0.05],但差異無統計學意義.PNS組血清IGF-1水平顯著低于健康對照組,差異有統計學意義[(155.75±17.48)μg/L比(223.17±16.44)μ/L,P<0.051,且與24 h尿蛋門量及CTx呈負相關(r=-0.757和r=-0.786,均P<0.05);與血BGP和BMD呈正相關(r=0.861和r=0.584,均P<0.05).結論 PNS患者(CKD 1、2期)存在骨代謝異常,錶現為骨形成減少、骨吸收增加.血清IGF-1與血BGP、CTx及BMD相關,可作為反映PNS患者骨代謝改變的臨床指標之一.
목적 탐토원발성신병종합정(PNS)환자혈청이도소양생장인자1(IGF-1)적변화급기여골대사지표지간적관계.평개IGF-1재PNS환자골대사이상궤제중적림상개치.방법 수궤선취2008년1월지2009년5월림상자료완정적만성신장병(CKD)1、2기PNS환자30례위대상;건강체검자61례위건강대조조.측정혈청IGF-1、개、린、PTH、25간기유생소D3[25-(OH)D3]골개소(BGP)、Ⅰ형효원필정교련C종단태(CTx)급뇨개/뇨기항(Uca/Cr).쌍능X선골밀도의창측환자골밀도(BMD). 결과여건강시조조비교,PNS조혈Ca、25-(OH)D3급BGP수평현저강저;혈CTx수평급Uca/Cr비치현저증고(균P<0.05);BMD수평강저[(1.078±0.090)g/cm2비(1.090±0.062)g/cm2,P>0.05],단차이무통계학의의.PNS조혈청IGF-1수평현저저우건강대조조,차이유통계학의의[(155.75±17.48)μg/L비(223.17±16.44)μ/L,P<0.051,차여24 h뇨단문량급CTx정부상관(r=-0.757화r=-0.786,균P<0.05);여혈BGP화BMD정정상관(r=0.861화r=0.584,균P<0.05).결론 PNS환자(CKD 1、2기)존재골대사이상,표현위골형성감소、골흡수증가.혈청IGF-1여혈BGP、CTx급BMD상관,가작위반영PNS환자골대사개변적림상지표지일.
Objective To study the change of serum insulin-like growth factor 1(IGF-1)in primary nephrotic syndrome(PNS)patients and its relationship with bone metabolism, and to investigate the clinical significance of IGF-1 in the mechanism of bone metabolic disorders in PNS patients. Methods A total of 30 PNS patients with chronic kidney disease(CKD)stage 1 and 2 were randomly selected from 2008.1 to 2009.5 in our hospital. Serum IGF-1, albumin, calcium, phosphorus, PTH,25 hydroxy vitamin D3, bone gla protein(BGP), degradation products of C-terminal telopeptides of type I collagen(CTx), 24-hour urinary protein excretion, and ratio of urinary calcium to creatinine(UCa/Cr)were measured. Healthy control group of 61 persons were randomly selected from our medical examination center at the same time. Results Serum levels of calcium, 25 hydroxy vitamin D3 and BGP were significantly lower;CTx and UCa/Cr were significantly higher in PNS patients(P<0.05)as compared to healthy control group. BMD of PNS patients was lower but without significant difference compared with healthy control group[(1.078± 0.090)g/cm2 vs(1.090±0.062)g/cm2, P>0.05]. Serum level of IGF-1 was significantly lower in PNS patients and was positively correlated with BMD and BGP,and negatively correlated with 24-hour urinary protein excretion and CTx. Conclusions Bone metabolic disorder exists in PNS patients with the appearance of decreased bone formation and increased bone absorption.Serum level of IGF-1 has good correlations with bone biochemical markers.which may be used as a new bone biochemical marker of bone metabolism in kidney disease.
