혈액투석중인 만성신부전 환자에서 골대사 지표로써의 Osteocalcin치 = Serum Osteocalcin as a Marker of Bone Metabolism in ESRD Patients on Hemodialysis

다국어 초록 (Multilingual Abstract)

Background : Serum osteocalcin is synthesized by osteoblast and has been shown to be sensitive indicator of bone turnover inpatients with various metabolic bone disease. In renal osteodystrophy, serum osteocalcin is elevated due to decreased renal clearance and elevated level of PTH. This study was done to evaluate the usefulness of serum osteocalcin as a marker of bone metabolism and the correlation with other biochemical markers of bone metabolism.
Methods : We measured serum osteocalcin, calcium, phosphorus, ALP(alkaline phosphatase) and PTH(parathyroid hormone) in 37 patients with end stage renal disease on hemodialysis. Osteocalcin was determined by radioimmunoassay and PTH was determined by radioimmunometric assay.
Results :
1) The mean level of serum osteocalcin in ESRD patients was 233.8± 218.2ng/ml which was significantly higher than that of controls(p<0.0001).
2) The mean level of serum PTH in ESRD patients was 40.5± 43.8pg/ml was significantly higher than that of controls(p<0.005).
3) There was a significant positive correlation between the level of serum PTH, ALP and the level of serum osteocalcin in ESRD patients.
4) By using multiple regression, PTH is most reliable factor that affect to elevated level of serum osteocalcin ( beta coefficient = 0.687, Sig T<0.05).
Conclusion : Serum osteocalcin as a marker of bone metabolism in ESRD patients is more useful than other biochemical marker such as serum calcium, phosphorus, ALP and PTH is a most reliable factor that affect to elevated level of serum osteocalin.