不同分期慢性肾脏病患者骨密度水平与胰岛素样生长因子-1表达的相关性  

Correlation of bone mineral density and IGF-1 in the different stages of patients with chronic kidney disease

作　　者：林建明[1] 杨霞[1] 袁静[1] 程世平[1] 查艳[1] 

机构地区：[1]贵州省人民医院肾脏泌尿疾病研究所,贵阳市550002

出　　处：《实用医学杂志》2013年第19期3166-3168,共3页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81200539);国际合作项目(编号:黔科合外G字[2012]7045号);省长基金项目[编号:黔省专合字(2010)89号]

摘　　要：目的：研究不同分期慢性肾脏病（CKD）患者血清胰岛素样生长因子-1（IGF-1）的表达与骨密度（BMD）的相关性。方法：选取CKD2～5期患者各25例，应用DEXA骨密度仪测定1～4腰椎前后位BMD和T值，检测血清IGF-1水平及其他相关生化指标的表达。结果：CKD5期患者BMD和T值与体检人群有明显差异（P〈0．05），血清IGF-1值显著减少（P〈0．01），血清甲状旁腺激素（iPTH）及碱性磷酸酶（ALP）明显增高（P〈0．01），且血清IGF-1水平与BMD呈正相关（r=0．673）。结论：BMD测定敏感性较高，是目前早期诊断肾性骨病的较好方法；血清IGF-1值不仅可反映骨转换水平高低，而且与CKD5期患者BMD的变化相平行，对CKD患者肾性骨病早期诊治和严重程度的判断亦具有重要临床价值。Objective To investigate the changes of bone mineral density （BMD）and insulin-like growth factor-1 （IGF-1） expressions in the different stages of chronic kidney disease （CKD）. Methods Twenty-five patients with the 2 - 5 stages of CKD were enrolled in this study. The BMD level was determined at the anteroposterior sites of LI-IA by using DEXA. Serum IGF-1, intact parathyroid hormone （iPTH） and alkaline phosphatase （ALP） were also determined. Results The BMD and the serum IGF-1 level of the CKD patients with stage 5 were significantly lower than those in the heahhy controls （P 〈 0.05）. The serum levels of iPTH and ALP in the CKD patients were higher than those of in the healthy controls （P 〈 0.05）. The serum IGF-1 level was positively correlated with BMD in the CKD patients with stage 5. Conclusion BMD is a sensitive diagnostic method for diagnosis of the CKD patients with early bone disorder. Serum IGF-1 level can be used as an early diagnosis and prognosis marker for CKD patients with renal osteodystrophy.

关 键 词：肾疾病 骨密度 IGF-1 

分 类 号：R692.9[医药卫生—泌尿科学]