目的:研究不同分期慢性肾脏病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值不仅可反应骨转换水平高低,而且与慢性肾脏病5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中亦具有重要临床价值。
Objective To investigate the correlation between bone mineral density ( BMD) and the expression of insulin-like growth factor-1(IGF-1) in patients with chronic kidney diseases (CKD) of the different stages.Methods Twenty-five patients with each stage of CKD (stage 2-5) were selected.BMD and the T value of the lumbar vertebrae (L1-L4) at the anteroposterior position were detected using DEXA.The serum levels of IGF-1 and other related biochemical indexes including intact parathyroid hormone ( iPTH) and alkaline phosphatase ( ALP) were also detected.Results BMD and the T values in patients with stage 5 CKD had significant difference to that in healthy controls (P<0.05).The serum level of IGF-1 decreased significantly compared with that in healthy controls (P<0.01), while the serum levels of iPTH and ALP increased significantly (P<0.05).The serum level of IGF-1 was positively correlated with BMD in patients with stage 5 CKD.Conclusion The detection of BMD has high sensitivity, which is a good diagnostic method for the diagnosis of renal osteopathy at the early stage.The serum level of IGF-1 can reflect the level of bone turnover, and parallels with the changes of BMD in patients with stage 5 CKD, showing important clinical value in both the early diagnosis and treatment of renal osteopathy in patients with CKD and the evaluation of the severity of the diseases.