Karaciğer transplantasyonunun kemik metabolizması ve gonad fonksiyonları üzerine etkisi
Küçük Resim Yok
Tarih
2005
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışma karaciğer transplantasyonunun (KCTx) kemik mineral yoğunluğu (KMY), kemik döngüsü, mineral metabolizması ve sex hormonları üzerine etkisini değerlendirmek amacıyla planlanmıştır. Lomber omurga ve kalça proksimali KMY’si, osteokalsin, deoksipridinolin (DPD), paratiroid hormon (PTH), serbest testesteron (ST), gonadotropinler, tiroid hormonları, büyüme hormonu (BH) ve kan / 24 saatlik idrarda Ca ve P değerlendirmesi yapılmak üzere, KCTx geçiren yaş ortalaması 43.5 ± 12.1 olan 51 hasta (34 erkek, 17 kadın) ile çalışılmıştır. Tüm ölçümler transplantasyon öncesi ve postoperatif 3.ayda olmak üzere 2 kez yapılmıştır. Başlangıçta lomber omurga T skorlarına göre 12 (%23.5) hasta osteoporoz, 22 (%43.1) hasta osteopenik olup, ortalama lomber omurga KMY’u 0.892 ± 0.1’di. Bununla birlikte, kalça boynu ve kalça totalinde osteoporoz daha az sayıda hastada izlenmiştir: 5 (%9.8) ve 4 (%7.8). KCTx sonrası 3.ayda KMY ölçümlerinde lomber omurga için %3.9, femur boynu için %5.3, total femur için %6.3’lük bir azalma saptandı, bu azalma tüm bölgeler için istatiksel olarak anlamlıydı (p<0.05). Tüm hastalarda tiroid hormonları, BH, PTH, kan Ca’u ve P’u, osteokalsin ve idrarla DPD atılımı normal sınırlardayken, kadınlarda FSH ve LH, erkeklerde ST değerleri normalden azdı. KCTx sonrası PTH, osteokalsin, DPD ve gonadotropinlerle erkeklerde ST düzeylerinde istatiksel olarak anlamlı bir artış saptandı (p<0.05). Hastaların ortalama karaciğer hastalığı süresiyle tüm bölgelerin KMY’ları arasında yüksek dereceli negatif bir korelasyon mevcuttu (p<0.01). Sonuç olarak bu çalışmada KCTx geçiren hastalarda artmış kemik döngüsüyle karakterize osteoporoz oranı yüksek bulunmuştur. KCTx sonrası karaciğer fonksiyonlarının normale dönmesi sex hormonlarının erken dönemde yükselmesi ile karakterizedir.
The present study was designed to evaluate the effects of liver transplantation (LT) on the bone mineral density (BMD), characteristics of bone turnover, mineral metabolism and sex hormons. Fifty one patients (34 men, 11 women) aged 43.5 ± 12.1, who underwent LT were studied, assessing the following parameters: lumbar spine and proximal femur BMD, osteocalcin, deoxypyridinoline (DPD), parathyroid hormone (PTH), free testesterone (FT), gonadotropins (FSH, LH), tyroid hormones, growth hormone (GH) and blood/ 24-hours urine Ca and P. All the measures were obtained at baseline and at 3rd month after LT. At baseline, 12 patients (%23.5) had osteoporosis, 22 patients (%43.1) had osteopenia and the mean BMD was 0.892 ± 0.1 for lumbar spine. Whereas, osteoporosis was seen less at femoral neck and total femur: 5 (%9.8) and 4 (%7.8), respectively. Three months after LT, 3.9% drop for lumbar spine, 5.3% drop for femur neck, 6.3% drop for total femur were observed, in BMD these decreases were statistically significant for all sites (p<0.05). The thyroid hormones, GH, PTH, blood Ca, P and osteocalcin levels and urinary DPD excretion were within normal range, while the levels of FSH and LH in women and level of FT in men were lower than normal range. After LT, statistically significant increases were observed in the PTH, osteocalcin, DPD, FSH, LH and FT levels (p<0.05). There was a highly significant negative correlation between duration of liver disease and all the BMD measures (p<0.01). Consequently, the increased osteoporosis ratio which was characterized by high bone turnover was found in patients who underwent LT in this study. The normalization of liver functions following LT was characterized by an early rise in sex hormones.
The present study was designed to evaluate the effects of liver transplantation (LT) on the bone mineral density (BMD), characteristics of bone turnover, mineral metabolism and sex hormons. Fifty one patients (34 men, 11 women) aged 43.5 ± 12.1, who underwent LT were studied, assessing the following parameters: lumbar spine and proximal femur BMD, osteocalcin, deoxypyridinoline (DPD), parathyroid hormone (PTH), free testesterone (FT), gonadotropins (FSH, LH), tyroid hormones, growth hormone (GH) and blood/ 24-hours urine Ca and P. All the measures were obtained at baseline and at 3rd month after LT. At baseline, 12 patients (%23.5) had osteoporosis, 22 patients (%43.1) had osteopenia and the mean BMD was 0.892 ± 0.1 for lumbar spine. Whereas, osteoporosis was seen less at femoral neck and total femur: 5 (%9.8) and 4 (%7.8), respectively. Three months after LT, 3.9% drop for lumbar spine, 5.3% drop for femur neck, 6.3% drop for total femur were observed, in BMD these decreases were statistically significant for all sites (p<0.05). The thyroid hormones, GH, PTH, blood Ca, P and osteocalcin levels and urinary DPD excretion were within normal range, while the levels of FSH and LH in women and level of FT in men were lower than normal range. After LT, statistically significant increases were observed in the PTH, osteocalcin, DPD, FSH, LH and FT levels (p<0.05). There was a highly significant negative correlation between duration of liver disease and all the BMD measures (p<0.01). Consequently, the increased osteoporosis ratio which was characterized by high bone turnover was found in patients who underwent LT in this study. The normalization of liver functions following LT was characterized by an early rise in sex hormones.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp
Kaynak
Osteoporoz Dünyasından
WoS Q Değeri
Scopus Q Değeri
Cilt
11
Sayı
2
