| 連載名 | ［連載］Clinical Investigation | |
|---|---|---|
| 題名 | 血液透析患者における閉経後骨粗鬆症の影響 | |
| 発刊年月 | 2010年 07月 | |
| 著者 | 斎藤 修 | 自治医科大学内科学講座腎臓内科学部門 |
| 著者 | 斎藤 孝子 | 自治医科大学内科学講座腎臓内科学部門 |
| 著者 | 朝倉 伸司 | すぎの木クリニック |
| 著者 | 草野 英二 | 自治医科大学内科学講座腎臓内科学部門 |
| 【 要旨 】 | 血液透析患者の骨折は，二次性副甲状腺機能亢進症の関与に加え，PTH低値でも骨折頻度が高いことが報告されている． PTH以外の因子について，今回われわれは血液透析患者における閉経後骨粗鬆症の影響について検証した． 維持期血液透析患者150名（男性97名，女性53名）を対象にして1年間骨折の発生率を調査し，年齢，性別，透析歴，腎不全原因疾患，血中NTx，BAP，iPTH濃度を検討項目として解析した．年間骨折率は5.3％（8名/150名）で，骨折者では非骨折者に比してNTxが有意に高値を示した．性差による解析では，女性患者群においてのみNTxと年齢との間に有意な正相関が認められ，女性患者では50歳代以降にNTx値が上昇し，70歳代で最大値を示した．男性患者群ではこのような傾向はみられなかった．以上より女性血液透析患者の骨折では閉経後骨粗鬆症による骨密度低下の関与が示唆され，NTxが閉経後骨粗鬆症の変化を知るうえで有用であると考えられた． |
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| Series | Clinical Investigation | |
|---|---|---|
| Title | The postmenopausal osteoporosis in patients on chronic hemodialysis | |
| Author | Osamu Saito | Division of Nephrology, Department of Medicine, Jichi Medical University |
| Author | Takako Saito | Division of Nephrology, Department of Medicine, Jichi Medical University |
| Author | Shinji Asakura | Suginoki Clinic |
| Author | Eiji Kusano | Division of Nephrology, Department of Medicine, Jichi Medical University |
| [ Summary ] | Bone fractures are not caused entirely by secondary hyperparathyroidism in chronic hemodialysis patients. Other factors may be involved in these patients' fractures. The aim of this study was to evaluate the effect of osteoporosis on bone density in hemodialysis patients. A total of 150 adult patients (97 male and 53 female) were enrolled in this prospective observation for one year, from August 2007 to July 2008. Episodes of bone fractures were assessed. NTx, BAP, and iPTH were also evaluated. Eight patients (5.3%) had bone fractures. NTx levels were elevated in these patients. In female dialysis patients, there were significant correlations between age and NTx levels. However, no correlation was seen in male patients. The levels of NTx gradually increased in female patients over 50 years old. The maximum values were seen in those who were 70 years old. There was no correlation between age and NTx levels in female dialysis patients. In conclusion, low bone density for postmenopausal osteoporosis may be involved in bone fractures in female hemodialysis patients. This study indicates that NTx levels may be an effective marker for postmenopausal osteoporosis in chronic hemodialysis patients. |
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