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.