Background: To evaluate bone-mineral-density-BMD determined by dual-energy X-ray absorptiometry-DEXA and bone turnover markers in chronic-kidney-disease-CKD patients. Method: An observational-clinical study of all pat...Background: To evaluate bone-mineral-density-BMD determined by dual-energy X-ray absorptiometry-DEXA and bone turnover markers in chronic-kidney-disease-CKD patients. Method: An observational-clinical study of all patients who were scanned by DEXA-scan in 2018. All patients with low-bone-density or osteoporosis-based on World-Health-Organization-WHO definition were included. Results: 505 patients with abnormal-BMD, 87.3% were in early-stage CKD-stage I - II, 8.5% were in CKD-stage III - V and 4.2% did not have renal tests. 95 (18.8%) were male with a mean age of 57.0 years and 410 (81.2%) were females with a mean age of 55.8 years. Patients of ≥65 years had lower T-score than those who were younger than 65 years-old. Among CKD patients, those with late-CKD (stage III - V) had less BMD-measurements and lower T-score than those with early-CKD (stage I - II). A significant positive correlation exists between parathyroid hormone-PTH-level and the lower T-score. Female had a worse T-score at the lumbar-region whereas male had a worse T-score at the femoral-region. There was no significant difference between males and females for the T-score at hip-region. Conclusion: We observed a distribution of abnormal BMD among different age, sex and CKD groups. Measurements of BMD by DEXA might be a useful test to diagnose osteoporosis in CKD patients. Femoral and total hip areas were more affected, however DEXA might not be able to detect osteoporosis in the lumbar area of CKD patients. T-scores are lower in patients with more severe CKD and lower in elderly patients. PTH level is associated proportionally to the degree of bone loss. Early intervention and proper management must be implemented early among CKD patients with multidisciplinary team approach strategy. More studies are needed to determine if DEXA techniques are enough to distinguish the quantity of bone loss between different stages of CKD.展开更多
目的探讨BMSCs移植治疗兔股骨头坏死(osteonecrosis of the femoral head,ONFH)后细胞在体内的存活情况及坏死股骨头内新骨形成情况。方法4～5月龄新西兰大白兔49只,雌性48只,雄性1只,体重2.0～2.5kg。取兔股骨及胫骨内骨髓,采用密度梯...目的探讨BMSCs移植治疗兔股骨头坏死(osteonecrosis of the femoral head,ONFH)后细胞在体内的存活情况及坏死股骨头内新骨形成情况。方法4～5月龄新西兰大白兔49只,雌性48只,雄性1只,体重2.0～2.5kg。取兔股骨及胫骨内骨髓,采用密度梯度离心法行BMSCs分离培养并传代。取第3代细胞行1,1’-双十八烷-3,3,3’,3’-四甲基吲哚羰花青-高氯酸盐(1,1’-dioctadecyl-3,3,3’,3’-tetramethylindocarbocyanine perchlorate,DiI)荧光标记,制备浓度为2.5×108个/mL细胞悬液。采用局部液氮注射冷冻法制备兔右侧ONFH模型。将雌兔随机分为3组,每组16只,A组单纯造模为对照,B组造模后注射自体DiI荧光标记BMSCs悬液4μL,C组造模后注射雄兔异体DiI荧光标记BMSCs悬液4μL。术后2、4、6、8周各组分别处死4只动物,行双侧股骨头X线观察,取股骨头标本行HE染色及Masson染色,测定新生骨小梁在股骨头所占的体积百分比。取心脏、肺、肝、脾、肾组织及股骨头标本组织,荧光显微镜下观察各组织中DiI荧光标记细胞的表达,PCR检测各组织中Y染色性别决定基因(sex determining region of the Y,Sry)的表达。结果术后动物均存活至实验完成。X线片示A组股骨头随时间延长逐渐出现骨坏死;B、C组股骨头骨密度逐渐增加,未出现骨坏死。组织学观察示B、C组随时间延长骨组织修复明显,A组无明显变化。各时间点B、C组新生骨小梁占股骨头体积百分比均高于A组,比较差异均有统计学意义(P<0.01),B、C组间比较差异无统计学意义(P>0.05)。术后各时间点B、C组心脏、肺、肝、脾、肾组织均未见DiI荧光标记细胞。PCR结果显示,3组各时间点心脏、肺、肝、脾、肾组织中均未见Sry基因表达;C组各时间点股骨头标本可见Sry基因的表达,A、B组未见。结论异体BMSCs移植后细胞可在股骨头局部存活并诱导新骨形成,并未见体内其他组织中再分布。展开更多
文摘Background: To evaluate bone-mineral-density-BMD determined by dual-energy X-ray absorptiometry-DEXA and bone turnover markers in chronic-kidney-disease-CKD patients. Method: An observational-clinical study of all patients who were scanned by DEXA-scan in 2018. All patients with low-bone-density or osteoporosis-based on World-Health-Organization-WHO definition were included. Results: 505 patients with abnormal-BMD, 87.3% were in early-stage CKD-stage I - II, 8.5% were in CKD-stage III - V and 4.2% did not have renal tests. 95 (18.8%) were male with a mean age of 57.0 years and 410 (81.2%) were females with a mean age of 55.8 years. Patients of ≥65 years had lower T-score than those who were younger than 65 years-old. Among CKD patients, those with late-CKD (stage III - V) had less BMD-measurements and lower T-score than those with early-CKD (stage I - II). A significant positive correlation exists between parathyroid hormone-PTH-level and the lower T-score. Female had a worse T-score at the lumbar-region whereas male had a worse T-score at the femoral-region. There was no significant difference between males and females for the T-score at hip-region. Conclusion: We observed a distribution of abnormal BMD among different age, sex and CKD groups. Measurements of BMD by DEXA might be a useful test to diagnose osteoporosis in CKD patients. Femoral and total hip areas were more affected, however DEXA might not be able to detect osteoporosis in the lumbar area of CKD patients. T-scores are lower in patients with more severe CKD and lower in elderly patients. PTH level is associated proportionally to the degree of bone loss. Early intervention and proper management must be implemented early among CKD patients with multidisciplinary team approach strategy. More studies are needed to determine if DEXA techniques are enough to distinguish the quantity of bone loss between different stages of CKD.
文摘目的探讨BMSCs移植治疗兔股骨头坏死(osteonecrosis of the femoral head,ONFH)后细胞在体内的存活情况及坏死股骨头内新骨形成情况。方法4～5月龄新西兰大白兔49只,雌性48只,雄性1只,体重2.0～2.5kg。取兔股骨及胫骨内骨髓,采用密度梯度离心法行BMSCs分离培养并传代。取第3代细胞行1,1’-双十八烷-3,3,3’,3’-四甲基吲哚羰花青-高氯酸盐(1,1’-dioctadecyl-3,3,3’,3’-tetramethylindocarbocyanine perchlorate,DiI)荧光标记,制备浓度为2.5×108个/mL细胞悬液。采用局部液氮注射冷冻法制备兔右侧ONFH模型。将雌兔随机分为3组,每组16只,A组单纯造模为对照,B组造模后注射自体DiI荧光标记BMSCs悬液4μL,C组造模后注射雄兔异体DiI荧光标记BMSCs悬液4μL。术后2、4、6、8周各组分别处死4只动物,行双侧股骨头X线观察,取股骨头标本行HE染色及Masson染色,测定新生骨小梁在股骨头所占的体积百分比。取心脏、肺、肝、脾、肾组织及股骨头标本组织,荧光显微镜下观察各组织中DiI荧光标记细胞的表达,PCR检测各组织中Y染色性别决定基因(sex determining region of the Y,Sry)的表达。结果术后动物均存活至实验完成。X线片示A组股骨头随时间延长逐渐出现骨坏死;B、C组股骨头骨密度逐渐增加,未出现骨坏死。组织学观察示B、C组随时间延长骨组织修复明显,A组无明显变化。各时间点B、C组新生骨小梁占股骨头体积百分比均高于A组,比较差异均有统计学意义(P<0.01),B、C组间比较差异无统计学意义(P>0.05)。术后各时间点B、C组心脏、肺、肝、脾、肾组织均未见DiI荧光标记细胞。PCR结果显示,3组各时间点心脏、肺、肝、脾、肾组织中均未见Sry基因表达;C组各时间点股骨头标本可见Sry基因的表达,A、B组未见。结论异体BMSCs移植后细胞可在股骨头局部存活并诱导新骨形成,并未见体内其他组织中再分布。
