AIM： To estimate the prevalence and identify the risk factors for metabolic bone disease in patients with cirrhosis. METHODS： The study was performed on 72 Indian patients with cirrhosis （63 male, 9 female; aged 〈...AIM： To estimate the prevalence and identify the risk factors for metabolic bone disease in patients with cirrhosis. METHODS： The study was performed on 72 Indian patients with cirrhosis （63 male, 9 female; aged 〈 50 years）. Etiology of cirrhosis was alcoholism （n = 37）, hepatitis B （n = 25） and hepatitis C （n = 10）. Twenty-three patients belonged to Child class A, while 39 were in class B and 10 in class C. Secondary causes for metabolic bone disease and osteoporosis were ruled out. Sunlight exposure, physical activity and dietary constituents were calculated. Complete metabolic profiles were derived, and bone mineral density （BMD） was measured using dual energy X ray absorptiometry. Low BMD was defined as a Z score below -2. RESULTS： Low BMD was found in 68% of patients. Lumbar spine was the most frequently and severely affected site. Risk factors for low BMD included low physical activity, decreased sunlight exposure, and low lean body mass. Calcium intake was adequate, with unfavorable calcium： protein ratio and calcium： phosphorus ratio. Vitamin D deficiency was highly prevalent （92%）. There was a high incidence of hypogonadism （41%）. Serum estradiol level was elevated significantly in patients with normal BMD. Insulin-like growth factor （IGF） 1 and IGF binding protein 3 levels were below the age-related normal range in both groups. IGF-1 was significantly lower in patients with low BMD. Serum osteocalcin level was low （68%） and urinary deoxypyridinoline to creatinine ratio was high （79%）, which demonstrated low bone formation with high resorption. CONCLUSION： Patients with cirrhosis have low BMD. Contributory factors are reduced physical activity, low lean body mass, vitamin D deficiency and hypogonadism and low IGF-1 level.展开更多
To investigate the status of mineral metabolism in people residing in huge regional centers of north-western and north-eastern parts of Russia by AES-IBP （atom-emission spectrometry with inductively bonded argon pla...To investigate the status of mineral metabolism in people residing in huge regional centers of north-western and north-eastern parts of Russia by AES-IBP （atom-emission spectrometry with inductively bonded argon plasma）, the content of 25 elements in hair samples of surveyed people was examined. The results of the study carried out in Russia＇s north could testify to significant deformation found in the elderly people bodies＇ element profiles. The pronounced deficit in such essential elements as Ca, Cr, Mg can be considered the common north-related profile typical for the elderly people from European and Asian north. In addition, age-related formation of all the elements＇ deficit due to their risen spending at pathologies as well as the increased need in such elements as Zn, Se, Cr, Cu, Mn. The age-related excess of arsenic proved to be typical for Magadan residents. In Anadyr, the age-related excess of lead was found, in Petrozavodsk mercury, and in Arkhangelsk--boron and aluminium.展开更多
Objective：We investigated whether disturbance of calcium and phosphate metabolism is associated with the presence and severity of calcific aortic valve disease （CAVD） in patients with normal or mildly impaired rena...Objective：We investigated whether disturbance of calcium and phosphate metabolism is associated with the presence and severity of calcific aortic valve disease （CAVD） in patients with normal or mildly impaired renal function. Methods：We measured serum levels of calcium, phosphate, alkaline phosphatase （AKP）, intact parathyroid hormone （iPTH）, 25-hydroxyvitamin D （25-OHD）, and biomarkers of bone turnover in 260 consecutive patients with normal or mildly impaired renal function and aortic valve sclerosis （AVSc） （n=164） or stenosis （AVS） （n=96） and in 164 age- and gender-matched controls. Logistic regression models were used to determine the association of mineral metabolism parameters with the presence and severity of CAVD. Results：Stepwise increases were observed in serum levels of calcium, phosphate, AKP, and iPTH from the control group to patients with AVS, and with reverse changes for 25-OHD levels （al P〈0.001）. Similarly, osteocalcin, procol agen I N-terminal peptide, andβ-isomerized type I col agen C-telopeptide breakdown products were significantly increased stepwise from the control group to patients with AVS （al P〈0.001）. In patients with AVS, serum levels of iPTH were positively, in contrast 25-OHD levels were negatively, related to trans-aortic peak flow velocity and mean pressure gradient. After adjusting for relevant confounding varia-bles, increased serum levels of calcium, phosphate, AKP, and iPTH and reduced serum levels of 25-OHD were in-dependently associated with the presence and severity of CAVD. Conclusions： This study suggests an association between mineral metabolism disturbance and the presence and severity of CAVD in patients with normal or mildly impaired renal function. Abnormal bone turnover may be a potential mechanism.展开更多
基金Supported by Corpus generated by Department of Endocrinology, KEM Hospital, Mumbai, India
文摘AIM： To estimate the prevalence and identify the risk factors for metabolic bone disease in patients with cirrhosis. METHODS： The study was performed on 72 Indian patients with cirrhosis （63 male, 9 female; aged 〈 50 years）. Etiology of cirrhosis was alcoholism （n = 37）, hepatitis B （n = 25） and hepatitis C （n = 10）. Twenty-three patients belonged to Child class A, while 39 were in class B and 10 in class C. Secondary causes for metabolic bone disease and osteoporosis were ruled out. Sunlight exposure, physical activity and dietary constituents were calculated. Complete metabolic profiles were derived, and bone mineral density （BMD） was measured using dual energy X ray absorptiometry. Low BMD was defined as a Z score below -2. RESULTS： Low BMD was found in 68% of patients. Lumbar spine was the most frequently and severely affected site. Risk factors for low BMD included low physical activity, decreased sunlight exposure, and low lean body mass. Calcium intake was adequate, with unfavorable calcium： protein ratio and calcium： phosphorus ratio. Vitamin D deficiency was highly prevalent （92%）. There was a high incidence of hypogonadism （41%）. Serum estradiol level was elevated significantly in patients with normal BMD. Insulin-like growth factor （IGF） 1 and IGF binding protein 3 levels were below the age-related normal range in both groups. IGF-1 was significantly lower in patients with low BMD. Serum osteocalcin level was low （68%） and urinary deoxypyridinoline to creatinine ratio was high （79%）, which demonstrated low bone formation with high resorption. CONCLUSION： Patients with cirrhosis have low BMD. Contributory factors are reduced physical activity, low lean body mass, vitamin D deficiency and hypogonadism and low IGF-1 level.
文摘To investigate the status of mineral metabolism in people residing in huge regional centers of north-western and north-eastern parts of Russia by AES-IBP （atom-emission spectrometry with inductively bonded argon plasma）, the content of 25 elements in hair samples of surveyed people was examined. The results of the study carried out in Russia＇s north could testify to significant deformation found in the elderly people bodies＇ element profiles. The pronounced deficit in such essential elements as Ca, Cr, Mg can be considered the common north-related profile typical for the elderly people from European and Asian north. In addition, age-related formation of all the elements＇ deficit due to their risen spending at pathologies as well as the increased need in such elements as Zn, Se, Cr, Cu, Mn. The age-related excess of arsenic proved to be typical for Magadan residents. In Anadyr, the age-related excess of lead was found, in Petrozavodsk mercury, and in Arkhangelsk--boron and aluminium.
基金Project supported by the Science and Technology Commission of Shanghai Municipality(No.114119a8800),China
文摘Objective：We investigated whether disturbance of calcium and phosphate metabolism is associated with the presence and severity of calcific aortic valve disease （CAVD） in patients with normal or mildly impaired renal function. Methods：We measured serum levels of calcium, phosphate, alkaline phosphatase （AKP）, intact parathyroid hormone （iPTH）, 25-hydroxyvitamin D （25-OHD）, and biomarkers of bone turnover in 260 consecutive patients with normal or mildly impaired renal function and aortic valve sclerosis （AVSc） （n=164） or stenosis （AVS） （n=96） and in 164 age- and gender-matched controls. Logistic regression models were used to determine the association of mineral metabolism parameters with the presence and severity of CAVD. Results：Stepwise increases were observed in serum levels of calcium, phosphate, AKP, and iPTH from the control group to patients with AVS, and with reverse changes for 25-OHD levels （al P〈0.001）. Similarly, osteocalcin, procol agen I N-terminal peptide, andβ-isomerized type I col agen C-telopeptide breakdown products were significantly increased stepwise from the control group to patients with AVS （al P〈0.001）. In patients with AVS, serum levels of iPTH were positively, in contrast 25-OHD levels were negatively, related to trans-aortic peak flow velocity and mean pressure gradient. After adjusting for relevant confounding varia-bles, increased serum levels of calcium, phosphate, AKP, and iPTH and reduced serum levels of 25-OHD were in-dependently associated with the presence and severity of CAVD. Conclusions： This study suggests an association between mineral metabolism disturbance and the presence and severity of CAVD in patients with normal or mildly impaired renal function. Abnormal bone turnover may be a potential mechanism.
