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        "resumen" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Background&#58;</span> Bone metabolism disorders in hemodialysed patients &#40;HD&#41; involve several humoral factors&#44; of which PTH plays the central role&#46; Leptin is usually found increased in renal failure and its link with bone metabolism&#160; has not been elucidated&#46; We investigated the BMD and bone metabolism&#160; in association with serum&#160; PTH&#44; 25OHD3 and leptin in HD patients&#46; <span class="elsevierStyleBold">Methods&#58; </span>We measured bone alkaline phosphatase &#40;bSAP&#41;&#44; cross linked N telopeptide of type 1 collagen &#40;NTx&#41;&#44; PTH&#44; 25OHD3 and leptin in 37 HD patients&#46; We also evaluated BMI and BMD in lumbar spine &#40;LS&#41; and in femoral neck &#40;FN&#41; by DXA&#46; Statistical evaluations were based on simple regression analysis&#46; <span class="elsevierStyleBold">Results&#58; </span>1&#41; Osteopenia was found in 32&#44;1&#37; in LS and 50&#37; in FN and osteoporosis in 14&#46;3&#37; and 21&#46;4&#37; of our patients&#44; respectively&#46; LS or FN Z score was not related&#160; to HD duration&#46; 2&#41; Bone markers&#44; PTH&#44; phosphorus and leptin levels were increased&#46; 3&#41; 25OHD3 was low and was not related to NTx&#44; bSAP or PTH&#46; 4&#41; PTH correlated with bone markers and Z score in LS and FN&#46; 5&#41; Leptin had no correlation with bone markers or Z score &#40;except BMI&#41;&#46; <span class="elsevierStyleBold">Conclusions&#58; </span>In our hemodialysed patients bone metabolism markers were increased in relation with high serum&#160; PTH levels&#46; The observed high serum leptin was not associated with bone metabolism&#46; Additionally the duration of hemodialysis did not appear to affect bone density&#46;<span class="elsevierStyleBold"></span></p>"
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Información de la revista
Vol. 32. Núm. 1.enero 2011
Páginas 1-132
Vol. 32. Núm. 1.enero 2011
Páginas 1-132
Acceso a texto completo
Densidad mineral y metabolismo óseo en pacientes en hemodiálisis. Correlación con la hormona paratifoidea, el 25(OH)D3 y la leptina
Bone mineral density and bone metabolism in hemodialysis patients. Correlation with PTH, 25OHD3 and leptin
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A.. Polymerisa, K.. Doumouchtsisa, E.. Grapsab
a Second Division of Endocrinology, Alexandra Hospital, Athens, Greece,
b Renal Unit, Alexandra Hospital, Athens, Greece,
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Antecedentes: Los trastornos del metabolismo óseo en pacientes en hemodiálisis (HD) implican varios factores humorales, de los cuales la función central recae sobre la hormona paratiroidea. Cuando hay insuficiencia renal normalmente se detectan niveles elevados de leptina y su relación con el metabolismo óseo está aún por esclarecer. Investigamos la densidad mineral ósea (DMO) y el metabolismo óseo en relación con la hormona paratiroidea sérica, el 25(OH)D3 y la leptina en pacientes en HD. Métodos: Medimos la fosfatasa alcalina ósea (FAO), el telopéptido N, la hormona paratiroidea, el 25(OH)D3 y la leptina en 37 pacientes en HD. Asimismo, evaluamos el IMC y la DMO en la columna lumbar (CL) y en el cuello femoral (CF) mediante DXA. Las evaluaciones estadísticas se basaron en análisis de regresión simples. Entrecruzamiento del telopéptido N del colágeno óseo tipo I. Resultados: 1) De nuestros pacientes, el 32,1% presentaba osteopenia en CL y 50% en CF y el 14,3% y el 21,4% osteoporosis, respectivamente. El puntaje Z en CL o CF no estaba relacionado con la duración de la HD. 2) Los marcadores óseos, la hormona paratiroidea, y los niveles de fósforo y leptina se vieron incrementados. 3) El 25(OH)D3 era bajo y no estaba relacionado con el telopéptido N, la FAO o la hormona paratiroidea. 4) La hormona paratiroidea estaba correlacionada con los marcadores óseos y con el puntaje Z en CL y CF. 5) La leptina no presentaba correlación con los marcadores óseos o con el puntaje Z (con excepción del IMC). Conclusiones: En nuestros pacientes en hemodiálisis, los marcadores del metabolismo óseo se vieron incrementados en relación con los niveles elevados de hormona paratiroidea sérica. La elevada leptina sérica observada no estaba asociada al metabolismo óseo. Además, la duración de la hemodiálisis no pareció afectar a la densidad ósea.

Palabras clave:
Hormona paratiroidea
Palabras clave:
Leptina
Palabras clave:
Hemodiálisis
Palabras clave:
Metabolismo óseo
Palabras clave:
Vitamina D3
Palabras clave:
Densidad mineral ósea

Background: Bone metabolism disorders in hemodialysed patients (HD) involve several humoral factors, of which PTH plays the central role. Leptin is usually found increased in renal failure and its link with bone metabolism  has not been elucidated. We investigated the BMD and bone metabolism  in association with serum  PTH, 25OHD3 and leptin in HD patients. Methods: We measured bone alkaline phosphatase (bSAP), cross linked N telopeptide of type 1 collagen (NTx), PTH, 25OHD3 and leptin in 37 HD patients. We also evaluated BMI and BMD in lumbar spine (LS) and in femoral neck (FN) by DXA. Statistical evaluations were based on simple regression analysis. Results: 1) Osteopenia was found in 32,1% in LS and 50% in FN and osteoporosis in 14.3% and 21.4% of our patients, respectively. LS or FN Z score was not related  to HD duration. 2) Bone markers, PTH, phosphorus and leptin levels were increased. 3) 25OHD3 was low and was not related to NTx, bSAP or PTH. 4) PTH correlated with bone markers and Z score in LS and FN. 5) Leptin had no correlation with bone markers or Z score (except BMI). Conclusions: In our hemodialysed patients bone metabolism markers were increased in relation with high serum  PTH levels. The observed high serum leptin was not associated with bone metabolism. Additionally the duration of hemodialysis did not appear to affect bone density.

Keywords:
PTH
Keywords:
Leptin
Keywords:
Hemodialysis
Keywords:
Bone metabolism
Keywords:
Vitamin D3
Keywords:
Bone mineral density
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