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Bone mineral density and urine calcium excretion among subjects with and without nephrolithiasis
被引:77
作者:
Asplin, JR
Bauer, KA
Kinder, J
Müller, G
Coe, BJ
Parks, JH
Coe, FL
机构:
[1] Litholink Corp, Chicago, IL 60612 USA
[2] Univ Chicago, Renal Sect, Chicago, IL 60637 USA
关键词:
kidney calculi;
osteopenia;
idiopathic hypercalciuria;
stone formation;
renal stones;
calcium diet;
D O I:
10.1046/j.1523-1755.2003.00763.x
中图分类号:
R5 [内科学];
R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号:
1002 ;
100201 ;
摘要:
Background. Bone mineral density (BMD) is reduced among patients with idiopathic hypercalciuria (IH) and nephrolithiasis. To disentangle effects of diet, stone formation, and physiology upon BMD, we studied vertebral and femoral neck BMD among relatives of hypercalciuric stone formers, and contrasted those with to those without stones. Methods. Among 59 subjects from 11 families, vertebral and femoral neck BMD, diet calcium intake, urine excretions of calcium, sodium, ammonium, titratable acid, sulfate, urea nitrogen, and serum levels of calcitriol and markers of bone turnover were studied. Results. Stone formers (SF) consumed less calcium than non-stone formers (NSF). Spine and femoral neck BMD z-scores varied inversely with urine calcium loss and urine ammonium excretion among SF but not NSF. No correlations of BMD z-score were found for bone markers, calcitriol, or any of the other measurements. Conclusion. SF consumed less calcium, presumably to prevent more stones, and displayed a bone mineral responsiveness to calcium loss and ammonium excretion not present among NSF, who ate more calcium. Lowered calcium consumption in IH, perhaps in response to stone formation, alters bone responses in a direction that can predispose to mineral loss and eventual fracture.
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页码:662 / 669
页数:8
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