title: Bone remodeling markers as lithogenic risk factors in patients with osteopenia-osteoporosis.
abstract: OBJECTIVE
  To analyze the presence of phosphocalcic metabolism disorders in patients with osteopenia-osteoporosis without nephrolithiasis with respect to a control group.
  
  
  METHODS
  A cross-sectional study was conducted in patients with osteopenia-osteoporosis without nephrolithiasis (n = 67) in lumbar spine or femur and in a control group (n = 61) with no lithiasis or bone disorders. Blood bone markers, phosphocalcic metabolism, fasting urine, 24-h urine lithogenic risk factors, and densitometry were recorded in both groups. SPSS 20.0 was used for statistical analysis.
  
  
  RESULTS
  In comparison with the controls, significantly higher blood calcium (9.27 ± 0.36 vs. 9.57 ± 0.38, p = 0.0001), intact parathormone (45.6 ± 14.9 vs. 53.8 ± 18.9, p = 0.008), and alkaline phosphatase (61.9 ± 20.9 vs. 70.74 ± 18.9, p = 0.014) levels were found in patients with osteopenia-osteoporosis. In the 24-h urine test, citrate (1010.7 ± 647.8 vs. 617.6 ± 315.8, p = 0.0001) and oxalate (28.21 ± 17.65 vs. 22.11 ± 16.49, p = 0.045) levels were significantly lower in osteopenia-osteoporosis patients than in controls, with no significant difference in calcium (187.3 ± 106.9 vs. 207.06 ± 98.12, p = 0.27) or uric acid (540.7 ± 186.2 vs. 511.9 ± 167.06, p = 0.35) levels. Patients with osteopenia-osteoporosis had significantly higher levels of lithogenic risk factors associated with bone remodeling, including significantly increased β-crosslaps and osteocalcin values and higher β-crosslaps/osteocalcin ratios.
  
  
  CONCLUSIONS
  Patients with osteopenia-osteoporosis without nephrolithiasis showed phosphocalcic metabolism disorders as well as lower urinary citrate and higher β-crosslaps/osteocalcin and fasting calcium/creatinine ratios, which would increase the risk of nephrolithiasis. Hence, prospective studies are warranted to evaluate the long-term risks.
authors.affiliation: Centro de Salud de Pinos Puente, Programa de Doctorado de Medicina Clínica y Salud Pública, Universidad de Granada, Granada, Spain.
authors.forename: María Sierra
authors.initials: MS
authors.lastname: Girón-Prieto
authors.affiliation: Facultad de Medicina, Universidad de Granada, Granada, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Arias-Santiago
authors.affiliation: UGC Urologia, Complejo Hospitalario Universitario Granada, Dr Virgili street, 9, bajo C. Huercal Overa, 04600, Granada, Spain.|Instituto IBS Granada, Granada, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Del Carmen Cano-García
authors.affiliation: UGC Analisis Clinicos, Hospital Santa Ana, Motril, Granada, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Poyatos-Andújar
authors.affiliation: UGC Analisis Clinicos, Hospital Universitario Granada, Granada, Spain.
authors.forename: Tomás
authors.initials: T
authors.lastname: de Haro-Muñoz
authors.affiliation: UGC Urologia, Complejo Hospitalario Universitario Granada, Dr Virgili street, 9, bajo C. Huercal Overa, 04600, Granada, Spain.|Instituto IBS Granada, Granada, Spain.
authors.forename: Felix
authors.initials: F
authors.lastname: Abad-Menor
authors.affiliation: UGC Endocrinología, Complejo Hospitalario Universitario Granada, Granada, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Quesada-Charneco
authors.affiliation: UGC Urologia, Complejo Hospitalario Universitario Granada, Dr Virgili street, 9, bajo C. Huercal Overa, 04600, Granada, Spain. arrabalp@ono.com.|Instituto IBS Granada, Granada, Spain. arrabalp@ono.com.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Arrabal-Polo
authors.affiliation: UGC Urologia, Complejo Hospitalario Universitario Granada, Dr Virgili street, 9, bajo C. Huercal Overa, 04600, Granada, Spain.|Instituto IBS Granada, Granada, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Arrabal-Martín
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood / Q000652:urine; D015519:Bone Density; D016723:Bone Remodeling; D002118:Calcium / Q000097:blood / Q000652:urine; D016022:Case-Control Studies; D019343:Citric Acid / Q000652:urine; D003094:Collagen / Q000652:urine; D003430:Cross-Sectional Studies; D005215:Fasting; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000097:blood / Q000652:urine; D015675:Osteocalcin / Q000652:urine; D010024:Osteoporosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000652:urine*; D019815:Oxalic Acid / Q000652:urine; D010281:Parathyroid Hormone / Q000097:blood; D010446:Peptide Fragments / Q000652:urine; D012307:Risk Factors; D014527:Uric Acid / Q000652:urine
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D010446:Peptide Fragments; C110762:glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine; D015675:Osteocalcin; D014527:Uric Acid; D019343:Citric Acid; D003094:Collagen; D019815:Oxalic Acid; D000469:Alkaline Phosphatase; D002118:Calcium
keywords: Bone markers; Lithogenic factors; Osteopenia; Osteoporosis