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OSTEOLOGICK¯ BULLETIN Redakâní RADA Âasopis Vûnovan˘ Problematice Skeletu ·Éfredaktor

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OSTEOLOGICK¯ BULLETIN Redakâní RADA Âasopis Vûnovan˘ Problematice Skeletu ·Éfredaktor OBSAH OSTEOLOGICK¯ BULLETIN REDAKâNÍ RADA âasopis vûnovan˘ problematice skeletu ·éfredaktor: Uωí rada: Doc. MUDr. Milan Bayer, CSc., Praha Doc. MUDr. ·tûpán Kutílek, CSc., Pardubice MUDr. Jan Rosa, Praha MUDr. Václav Vyskoãil, Ph.D., PlzeÀ âlenové: Prof. MUDr. Jaroslav Blaho‰, DrSc., Praha Prof. MUDr. Petr Broulík, DrSc., Praha Prof. MUDr. Rajko Doleãek, DrSc., Ostrava Doc. MUDr. Josef Donát, DrSc., Hradec Králové Prof. MUDr. Rastislav Dzúrik, DrSc., Bratislava, SR MUDr. Petr Kasalick˘, CSc., Praha Prof. Roman S. Lorenc, M. D., Ph. D., OBSAH Warszawa, PL MUDr. Pavol Masaryk, CSc., Pie‰Èany, SR PÒVODNÍ PRÁCE Prof. MUDr. Vladimír Paliãka, CSc., Hradec Králové Prof. MUDr. Juraj Payer Jr., CSc., Bratislava, SR Vztah mezi koncentrací vitaminu D a denzitou kostní tkánû 43 Prof. Dr. med. Meinrad Peterlik, Wien, A P. Îivn˘, L. Pavlíková, J. ·pirková, V. Paliãka Jonathan Reeve, DM, DSc, FRCP, Cambridge, UK Prof. MUDr. Jozef Rovensk˘, DrSc., Pie‰Èany, SR KAZUISTIKA Prof. Leon Sokoloff, M. D., Setauket, USA MUDr. Ivo Sotorník, DrSc., Praha Osteoporóza – dominantní iniciální projev nesekretorické Prof. MUDr. Jan ·tûpán, DrSc., Praha formy mnohoãetného myelomu 48 Prof. MUDr. Karel Trnavsk˘, DrSc., Praha Prof. MUDr. Ivana Îofková, DrSc., Praha T. Pika, M. Zemanová, T. Kraina, D. Hrabovsk˘, V. ·ãudla Kalcifylaxe 51 ·enk F. VYDAVATEL: ZPRÁVY Z CEST Osteologické postfiehy odjinud. The 8th European Congress of Endocrinology, Glasgow, 1–5 April 2006 57 I. Îofková Adresa redakce a pfiíjem inzerce: Trios, s. r. o. INFORMACE Zakoufiilova 142, 149 00 Praha 4-Chodov Odborné usmernenie pre diagnostiku a lieãbu osteoporózy tel.: 267 912 030, fax: 267 915 563 e-mail: [email protected] v Slovenskej republike 58 Redakce: Hana Gebauerová, Mgr. Hedvika Tvrdá Îivotopisy nov˘ch ãlenÛ vedení spoleãnosti SMOS 64 Inzerce: Hana Gebauerová Sazba: SILVA, s. r. o. Ze svûtové literatury 66 Pod Dûkankou 82, Praha 4 Osteologick˘ kongres v Pre‰ove 7.–9. septembra 2006 – Abstrakta 70 e-mail: [email protected] Tisk: Grafotechna, L˘skova 1594/33, Praha 13-StodÛlky ZPRÁVA Vychází 4x roãnû. Pfiíteli profesoru Paliãkovi 82 Povoleno Ministerstvem kultury âR J. Blaho‰ pod ã. MK âR 7352. Kongres IOF v Torontu, Kanada 83 ISSN 1211-3778 Podávání novinov˘ch zásilek povolila âeská po‰ta P. Horák s. p., od‰tûpn˘ závod Praha, ã. j. nov. 6063/96 ze dne 9. 5. 1996. Vydavatel nenese odpovûdnost za údaje a názory autorÛ jednotliv˘ch ãlánkÛ nebo inzercí. Souãasnû si vyhrazuje právo na drobné stylistické úpravy ãlán- kÛ. Zaslané pfiíspûvky se nevracejí, jsou archivová- ny v redakci TRIOS, na poÏádání vrátí redakce obra- zovou dokumentaci. Oti‰tûné pfiíspûvky nejsou ho- norovány. Îádná ãást tohoto ãasopisu nesmí b˘t bez pfied- chozího písemného souhlasu vlastníka autorsk˘ch práv kopírována a rozmnoÏována za úãelem dal‰ího roz‰ifiování v jakékoliv formû ãi jak˘mkoliv zpÛso- bem (aÈ mechanick˘m, nebo elektronick˘m – vãetnû pofiizování fotokopií, nahrávek ãi informaãních data- bází). Osteologick˘ bulletin 2006 ã. 2–3 roã. 11 41 OBSAH OSTEOLOGICAL BULLETIN A journal devoted to problems of the skeleton EDITORIAL BOARD Editor in Chief: Advisory Board: Doc. MUDr. Milan Bayer, CSc., Praha Doc. MUDr. ·tûpán Kutílek, CSc., Pardubice MUDr. Jan Rosa, Praha MUDr. Václav Vyskoãil, Ph.D., PlzeÀ Editorial Board: Prof. MUDr. Jaroslav Blaho‰, DrSc., Praha Prof. MUDr. Petr Broulík, DrSc., Praha Prof. MUDr. Rajko Doleãek, DrSc., Ostrava Doc. MUDr. Josef Donát, DrSc., Hradec Králové CONTENTS Prof. MUDr. Rastislav Dzúrik, DrSc., Bratislava, SR MUDr. Petr Kasalick˘, CSc., Praha Prof. Roman S. Lorenc, M. D., Ph. D., ORIGINAL ARTICLE Warszawa, PL The relationship between vitamin D concentration MUDr. Pavol Masaryk, CSc., Pie‰Èany, SR Prof. MUDr. Vladimír Paliãka, CSc., Hradec Králové and bone mineral density 43 Prof. MUDr. Juraj Payer Jr., CSc., Bratislava, SR P. Îivn˘, L. Pavlíková, J. ·pirková, V. Paliãka Prof. Dr. med. Meinrad Peterlik, Wien, A Jonathan Reeve, DM, DSc, FRCP, Cambridge, UK CASE REPORT Prof. MUDr. Jozef Rovensk˘, DrSc., Pie‰Èany, SR Prof. Leon Sokoloff, M. D., Setauket, USA Osteoporosis – a dominant and initial manifestation MUDr. Ivo Sotorník, DrSc., Praha of nonsecretory multiple myeloma 48 Prof. MUDr. Jan ·tûpán, DrSc., Praha Prof. MUDr. Karel Trnavsk˘, DrSc., Praha T. Pika, M. Zemanová, T. Kraina, D. Hrabovsk˘, V. ·ãudla Prof. MUDr. Ivana Îofková, DrSc. Calciphylaxis 51 ·enk F. ZPRÁVY Z CEST th PUBLISHER: News in osteology. The 8 European Congress of Endocrinology, Glasgow, 1–5 April 2006 57 I. Îofková INFORMATIONS Editorial office: Recommended guidelines for the diagnosis and treatment Trios Ltd. Zakoufiilova 142, 149 00 Praha 4-Chodov of postmenopausal osteoporosis in the Slovak republic 58 tel.: 267 912 030, fax: 267 915 563 Czech Society for Metabolic Bone Diseases (SMOS) – e-mail: [email protected] Hana Gebauerová, Mgr. Hedvika Tvrdá CVs of the new Council members 64 Advertising: Hana Gebauerová News from around the world 66 Congress of SMOS, Pre‰ov, September 7.–9. 2006 – Abstracts 70 DTP: SILVA Ltd. Pod Dûkankou 82, Praha 4 e-mail: [email protected] NEWS Printed by: Grafotechna Ltd. To my friend prof. Paliãka 82 L˘skova 1594/33, Praha 13-StodÛlky J. Blaho‰ 4 issues per volume. Congress of IOF in Toronto, Canada 83 ISSN 1211-3778 P. Horák Copyright © Trios Ltd. All rights reseved. The views expressed in this journal are not neces- sarily those of the Editor or Editorial Board. 42 Osteological Bulletin 2006 No. 2–3 Vol. 11 PÒVODNÍ PRÁCE Vztah mezi koncentrací vitaminu D a denzitou kostní tkánû P. ÎIVN¯, L. PAVLÍKOVÁ, J. ·PIRKOVÁ, V. PALIâKA Osteocentrum, Ústav klinické biochemie a diagnostiky, Lékařská fakulta Univerzity Karlovy a Fakultní nemocnice v Hradci Králové SOUHRN Živný P., Pavlíková L., Špirková J., Palička V.: Vztah mezi koncentrací vitaminu D a denzitou kostní tkáně Vitamin D hraje mimo jiné významnou roli i v mineralizaci kosti a jeho deficit je rizikovým faktorem pro vznik osteomalacie (denzita kostního mine- rálu) a osteoporózy. Deficit vitaminu D negativně ovlivňuje metabolismus vápníku a fosforu a způsobuje vzestup parathormonu. Nízké koncentrace vi- taminu D, vápníku a fosforu jsou spojeny se zvýšením rizika fraktur v oblasti proximálního femoru u starších žen. Cílem této studie je zhodnotit vztah mezi – bone mineral density (BMD) a sérovou koncentrací 25-hydroxyvitaminu D (25 OHD) a 1,25-dihydroxyvitaminu D (1,25 OHD) u postmeno- pauzálních žen. Metody: Retrospektivní studie zahrnuje 157 postmenopauzálních žen kavkazských etnických skupin ve věku 38–79 let. BMD (g/cm2) byla měřena v ob- lasti bederní páteře (L1–L4) a proximálního femoru na DEXA denzitometru Hologic Delphi A. Dále byly stanoveny koncentrace osteokalcinu a pa- rathormonu v séru pomocí imunoeseje (EIA, Modular Roche E 170), kostní izoenzym alkalické fosfatázy (METRA BAP EIA set). Ionizovaný vápník byl stanoven pomocí iontově selektivní elektrody. Vitaminy 25 OHD a 1,25 OHD byly stanoveny pomocí radioimunoeseje. Statistické analýzy byly pro- vedeny na softwaru SigmaStat 3.1 (Jandel Scientific Corporation, San Rafael, CA, USA), použity byly testy: lineární regrese a korelace dle Pearsona. Výsledky: Byla prokázána korelace mezi vitaminy 25 OHD a 1,25 OHD (r = 0,232, p = 0,008) a mezi vápníkem a ionizovaným vápníkem (r = 0,831, p = 0,001). Korelační analýza neprokázala korelaci mezi BMD v oblasti bederní páteře a koncentrací 1,25 OHD (r = –0,143, p = 0,119) a mezi BMD v ob- lasti proximálního femoru a 25 OHD (r = 0,113, p = 0,224), stejně jako mezi BMD a koncentracemi osteokalcinu a parathormonu. Závěry: Nebyla nalezena korelace mezi BMD, vitaminy D a ostatními vyšetřovanými markery kostní přestavby, které mohou naznačovat možnou po- rušenou rovnováhu mezi kostní formací a resorpcí u postmenopauzálních žen. Někteří autoři naznačují, že přímý vztah mezi koncentrací vitaminu D a BMD je zpravidla výsledkem přítomnosti ještě dalších patologických stavů, zejména spojených s poškozením ledvin. Podpořeno výzkumným zámě- rem MZO 00179 906. Klíčová slova: vitamin D, bone mineral density, osteokalcin, parathormon, korelace SUMMARY Živný P., Pavlíková L., Špirková J., Palička V.: The relationship between vitamin D concentration and bone mineral density Aims: Vitamin D plays an important role in the normal bone mineralization and its deficiency is a risk factor for osteomalacia and osteoporosis. Vita- min D deficiency negatively impairs calcium and phosphate metabolism and trigger parathyroid hormone (PTH) increase. Low levels of vitamin D, calcium and phosphate have also been linked to increase in hip fractures in elderly women. The aim of this study was to evaluate relationship between bone mineral density (BMD) and serum levels of 25-hydroxyvitamin D (25 OHD) and 1,25-dihydroxyvitamin D (1,25 OHD) in postmenopausal women. Methods: This retrospective study included 157 postmenopausal Caucasian women, age 38–79. BMD (g/cm2) was measured at the lumbar spine (L1–L4) and proximal femur using the Hologic Delphi A DEXA densitometer. Osteocalcin and PTH concentrations were determined by monoclonal competitive enzyme immunoassay (EIA, Modular Roche E170), bone-specific alkaline phosphatase by METRA BAP EIA kit. Ionized calcium were de- termined by ion-selective electrode. Radioimmunoassay was used to measure vitamin 25 OHD and 1,25 OHD. Statistical analyses were performed using SigmaStat 3.1 (Jandel Scientific Corporation, San Rafael, CA, USA), test used were linear regression and Pearson correlation. Results: Obtained results showed correlation between vitamin 25 OHD and 1,25 OHD (r = 0.232, p = 0.008) and between calcium and ionized calcium (r = 0.831, p = 0.001). Correlation analyses showed lack of correlation between lumbar spine BMD and concentration 1,25 OHD (r = –0.143, p = 0.119), between proximal femur BMD and 25 OHD (r = 0.113, p = 0.224), as well between BMD and osteocalcin and PTH concentrations. Conclusions: We did not find correlation between BMD measurement, vitamin D and all investigated bone markers that indicates possible impaired balance between bone formation and bone resorption in postmenopausal women. Some authors stated that direct relation between vitamin D and BMD concentration is the result of pathological conditions with renal impairment.
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