ROL' POLOVYKh GORMONOV V REGULYaTsII KOSTNOGO OBMENA i mineral'noy plotnostikostnoy tkani u muzhchin v pozdnie sroki posle allotransplantatsii trupnoy pochki

Abstract

Lumbal spine and hip bone mineral density (BMD), bone turnover markers [bone alkaline phosphatase (bALP), osteocalcin (OC), aminoterminal procollagen I propeptide, bone acid phosphatase (bACP), ß-crosslaps (CTX)], sex hormones [testosterone, estradiol (E2), sex hormone-binding globulin (SHBG), free androgen index (FAI), free estrogen index (FEI)], parathyroid hormone (PTH), osteoprotegerin (OPG) and insulin-like growth factor-1 (IGF-1)] were determined in 39 men in age 42±10 years (33 with well renal function and 6 - with renal failure (RF) 44±26 months following KT receiving triple immunosuppressive therapy (CysA, prednisolone and azathioprine). Increased CTX, bACP, OC and decreased bALP so as BMD were associated in men following KT with low testosterone, SHBG and IGF-1 and high E2, OPG and PTH. There was more degree of bone turnover disturbances, decreased BMD, PTH hypersecretion and low FAI in RF. There were significant positive relationships between serum testosterone and E2, FEI and FAI, bALP and E2, bALP and FEI, femur BMD and FAI, femur BMD and FEI, OPG and E2, IGF-1 and PTH. There were significant inverse correlations between serum CTX and FAI, CTX and FEI, hip (spine) BMD and SHBG, hip (spine) BMD and PTH so as between PTH and FAI, PTH and FEI. So bone turnover disturbances, hip BMD losses and PTH hypersecretion in men at late time following KT associated with sex hormone deficiency. Predictor of high bone turnover and as vertebral as femur bone losses after KT besides PTH hypersecretion was serum SHBG. Decreased IGF-1 was the reason of bone forming suppression and possibly was following cyclosporine hepatotoxicity. OPG increasing was associated partly with high estradiol and was compensatory to attenuation of bone resorption and bone losses.