[Microalbuminuria as a risk factor for diabetic osteopathy in patients with IDDM and renal sufficiency].
Disturbances in bone marrow vascularisation can be one of the causes of diabetic osteopathy. The aim of the study was to answers the question if microalbuminuria as a results of capillary injury can be a sign of bone mineralisation disorders in IDDM renal sufficient patients. We examined 60 IDDM patients (30 women without menstruation disturbances; 30 men; age 25-36 years old). All the observed subjects were divided into groups: I-30 normoalbuminuric patients (0-29 mg/24 h); II-30 microabuminuric patients (30-295 mg/24 h). Bone mineral density (BMD) of femoral neck, lumbar spine (L2-L4) and total body was measured by dual energy X-ray absorptiometry (DEXA, Lunar). The biochemical parameters of bone turnover were measured both in serum and urine as follows: osteocalcine, total hydroxyproline (HPR, HPR/Cr), total alkaline phosphatase (AP) with bone fraction, total calcium (Ca, Ca/Cr) and inorganic phosphor (P). Microalbuminuric patients presented more severe bone turnover disturbances, shown by differences in: BMD and Z-score for femoral neck (p < 0.05), serum HPR (p < 0.05), AP (p < 0.05), AP (p < 0.01) and its bone fraction (p < 0.05). We proved the presence of statistically significant correlation coefficients for albuminuria and some densytometric and biochemical bone parameeters. Our results suggest that microalbuminuria can indirectly indicate the dynamic of bone turnover derangement in IDDM course. They are present mostly in the femoral neck, which because of the vascularisation type is particularly susceptible to subalimentation in the diabetic microangiopathy course.
Goliat
E
E
Katedra i Klinika Chorób Wewnetrznych i Nefrologii Akademii Medycznej w Warszawie.
Marusza
W
W
Ostrowski
K
K
Lipińska
A
A
D015502:Absorptiometry, Photon; D000328:Adult; D000419:Albuminuria / Q000175:diagnosis / Q000209:etiology*; D000469:Alkaline Phosphatase / Q000097:blood / Q000652:urine; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000209:etiology*; D002118:Calcium / Q000097:blood / Q000652:urine; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D006801:Humans; D006909:Hydroxyproline / Q000097:blood / Q000652:urine; D007677:Kidney Function Tests; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D015675:Osteocalcin / Q000097:blood / Q000652:urine; D012307:Risk Factors
D015675:Osteocalcin; D000469:Alkaline Phosphatase; D006909:Hydroxyproline; D002118:Calcium