nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2021-25-6-63-70nefr-2051Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSРоль регуляторов костного метаболизма склеростина и остеопротегерина в развитии кардиоваскулярных осложнений на поздних стадиях хронической болезни почекThe role of bone metabolism regulators sclerotin and osteoprotegerin in the development of cardiovascular complications in the late stages of chronic kidney diseasehttps://orcid.org/0000-0002-7314-9063ДзгоеваФ. У.DzgoevaF. U.

Проф. Дзгоева Фатима Урузмаговна

362040, Республика Северная Осетия-Алания, Владикавказ, ул. Пушкинская, д. 40. Тел.: +7(918)822-83-45

Prof. Fatima U. Dzgoeva - MD, PhD, DMedSci, professor, Department of Internal Medicine № 5.

362040, Republic of North Ossetia-Alania Vladikavkaz, Pushkinskaya 40, Phone: +7(918)822-83-45

fdzgoeva@mail.ruhttps://orcid.org/0000-0003-4175-5365РемизовО. В.RemizovO. V.

Проф. Ремизов Олег Валерьевич - кафедра лучевой диагностики с лучевой терапией и онкологией.

362040, Республика Северная Осетия-Алания, Владикавказ, ул. Пушкинская, д. 40. Тел.: +7(867)530397

Prof. Oleg V. Remizov - MD, PhD, DMedSci, Department of Radiology with radiotherapy and oncology, professor.

362040, Republic of North Ossetia-Alania, Vladikavkaz, Pushkinskaya 40, Phone: 7(867)530397

oleg_remizov@mail.ruhttps://orcid.org/0000-0002-0539-8666БоциеваВ. Х.BotsievaV. Kh.

Аспирант Боциева Виктория Хадзибатровна, кафедра биохимии.

362040, Республика Северная Осетия-Алания, Владикавказ, ул. Пушкинская, д. 40. Тел.: +7(928)857-33-55

Victoria H. Botsieva - postgraduate student, Department of Biochemistry.

362040, Republic of North Ossetia-Alania,Vladikavkaz, Pushkinskaya 40, Phone: +7(928)857-33-55

bosionvi@yandex.ruhttps://orcid.org/0000-0001-5564-9948МалаховаН. Г.MalakhovaN. G.

Аспирант Малахова Нина Геннадиевна - кафедра акушерства и гинекологии №1.

362040, Республика Северная Осетия-Алания, Владикавказ, ул. Пушкинская, д. 40. Тел.: +7(988)8386237

Nina G. Malakhova - postgraduate student, Department of Obstetrics and Gynecology No. 1.

362040, Republic of North Ossetia-Alania,Vladikavkaz, Pushkinskaya 40, Phone: +7(988)8386237

missis.sviv2014@yandex.ruhttps://orcid.org/0000-0002-4183-2335ИкоеваЗ. Р.IkoevaZ. R.

Аспирант Икоева Зарина Руслановна - кафедра внутренних болезней №5.

362040, Республика Северная Осетия-Алания, Владикавказ, ул. Пушкинская, д. 40. Тел.: +7(918)8304719

Zarina R. Ikoeva, postgraduate student, Department of Internal Medicine №5.

362040, Republic of North Ossetia-Alania,Vladikavkaz, Pushkinskaya 40, Phone: +7(918)8304719

zariikosha@mail.ruhttps://orcid.org/0000-0001-5310-889XГолоеваВ. Г.GoloevaV. G.

Аспирант Голоева Виктория Герсановна

362040, Республика Северная Осетия-Алания, г. Владикавказ, ул. Пушкинская, д. 40. Тел.:+7(960)4015003

Victoria G. Goloeva - postgraduate student, Department of Internal Medicine №5.

362040, Republic of North Ossetia-Alania,Vladikavkaz, Pushkinskaya 40, Phone: +7(960)4015003

vgoloeva@yandex.ruhttps://orcid.org/0000-0002-7257-2812ГирееваЕ. Ю.GireyevaE. Yu.

Доц. Гиреева Елена Юрьевна - кандидат медицинских наук.

362040, Республика Северная Осетия-Алания, г. Владикавказ, ул. Пушкинская, д. 40. Тел.: +7(928)4972808

Associate Prof. Elena Yu. Gireeva - MD, PhD, Department of Internal Medicine №5.

362040, Republic of North Ossetia-Alania,Vladikavkaz, Pushkinskaya 40, Phone: +7(928)4972808

geiu-dag@mail.ruhttps://orcid.org/0000-0002-6562-9964ГуринаА. Е.GurinaA. E.

Доц. Гурина Алла Евгеньевна - кандидат медицинских наук, кафедра биохимии, заведующая кафедрой.

362040, Республика Северная Осетия-Алания, Владикавказ, ул. Пушкинская, д. 40. Тел.: +7(918)8258355

Associate prof. Alla E. Gurina - MD, PhD, Department of Biochemistry, Head of Department.

362040, Republic of North Ossetia-Alania,Vladikavkaz, Pushkinskaya 40, Phone: +7(918)8258355

allagurina@yandex.ruhttps://orcid.org/0000-0003-0514-3038ЦаллаговаЛ. В.TsallagovaL. V.

Проф. Цаллагова Лариса Владимировна - кафедра акушерства и гинекологии №1, заведующая кафедрой.

362040, Республика Северная Осетия-Алания, г. Владикавказ, ул. Пушкинская, д. 40. Тел.: +7(918)8278686

Larisa V. Tsallagova - MD, PhD, DMedSci, Department of Obstetrics and Gynecology No 1, Head of Department.

362040, Republic of North Ossetia-Alania,Vladikavkaz, Pushkinskaya 40, Тел.: +7(918)8278686

Profesortsallagova@mail.ruСеверо-Осетинская государственная медицинская академияРоссияNorth Ossetian State Medical AcademyRussian Federation2021171120212566370Copyright © Дзгоева Ф.У., Ремизов О.В., Боциева В.Х., Малахова Н.Г., Икоева З.Р., Голоева В.Г., Гиреева Е.Ю., Гурина А.Е., Цаллагова Л.В., 20212021Дзгоева Ф.У., Ремизов О.В., Боциева В.Х., Малахова Н.Г., Икоева З.Р., Голоева В.Г., Гиреева Е.Ю., Гурина А.Е., Цаллагова Л.В.Dzgoeva F.U., Remizov O.V., Botsieva V.K., Malakhova N.G., Ikoeva Z.R., Goloeva V.G., Gireyeva E.Y., Gurina A.E., Tsallagova L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/2051ВВЕДЕНИЕ

ВВЕДЕНИЕ. Кардиоваскулярные осложнения, обусловленные кальцификацией сосудов при хронической болезни почек (ХБП), тесно связаны с нарушениями костно-минерального метаболизма, механизмы которых требуют дальнейшего изучения.

ЦЕЛЬ

ЦЕЛЬ: уточнить роль белков-регуляторов костного метаболизма склеростина и остеопротегерина в процессах сосудистой кальцификации и развитии кардиоваскулярных осложнений при ХБП.

ПАЦИЕНТЫ И МЕТОДЫ

ПАЦИЕНТЫ И МЕТОДЫ. Обследовано 110 пациентов с ХБП 3-5D стадии (67 мужчин). Медиана возраста - 47,0 (23,0-68,0) лет. Остеопротеге-рин (ОПГ), склеростин, интактный паратгормон (иПТГ), тропонин I в сыворотке крови определяли с использованием коммерческих наборов «Enzyme-linked Immunosorbent Assay Kit for Sclerostin» («Cloude-CloneCorp.» (США) и коммерческих наборов «ELISA kit» («Biomedica» (Австрия) методом иммуноферментного анализа (ИФА). Эхокардиографию с допплерографией проводили на аппарате «ALOKA 4000» («Tochiba», Япония). Определяли индекс массы миокарда левого желудочка (ИММЛЖ) и пиковую систолическую скорость кровотока в дуге аорты (Vps, peak systolic velocity) для количественной оценки гемодинамических изменений, косвенно свидетельствующих о состоянии сосудистой стенки.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. Анализ соотношений величин расчетной скорости клубочковой фильтрации (рСКФ), ИММЛЖ, Vps, ОПГ и склеростина показал, что снижение экскреторной функции почек сопровождается увеличением концентраций ОПГ и склеростина в сыворотке крови. При этом отмечается увеличение ИММЛЖ и Vps. При проведении корреляционного анализа было показано, что уровень ОПГ был положительно взаимосвязан с уровнем склеростина и отрицательно - с уровнем иПТГ.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. В нашем исследовании получены данные, подтверждающие интерактивное взаимодействие между сосудистой и костной системами. Морфогенетические белки-ингибиторы костного метаболизма (склеростин и ОПГ) играют значительную роль в поражении сердечно-сосудистой системы у больных с ХБП, так как способствуют развитию сосудистой кальцификации.

BACKGROUND

BACKGROUND. Cardiovascular complications caused by vascular calcification in chronic kidney disease (CKD) are closely related to disorders of bone and mineral metabolism, the mechanisms of which require further study.

THE AIM

THE AIM: to clarify the role of the regulatory proteins of bone metabolism of sclerostin and osteoprotegerin in the processes of vascular calcification and the development of cardiovascular complications in CKD.

PATIENTS AND METHODS

PATIENTS AND METHODS. 110 patients with stage 3-5D CKD (67 men) were examined. Median age is 47.0 (23.0-68.0) years. Osteoprotegerin (OPG), sclerostin, intact parathyroid hormone (IPTG), troponin I in blood serum were determined using commercial kits "Enzyme-linked Immunosorbent Assay Kit for Sclerostin" ("Cloud-Clone Corp.", USA) and commercial kits "ELISA kit" ("Biomedica" (Austria) by enzyme immunoassay (ELISA). Echocardiography with Dopplerography was performed on the device "ALOKA 4000" ("Toshiba", Japan). The left ventricular myocardial mass index (LVMI) and peak systolic blood flow velocity in the aortic arch (Vps, peak systolic velocity) were determined to quantify hemodynamic changes indirectly indicating the state of the aortic vascular wall.

RESULTS

RESULTS. Analysis of the ratios of the calculated glomerular filtration rate (EGFR), IMLJ, Vps, OPG, and sclerostin showed that a decrease in excretory kidney function is accompanied by an increase in the concentrations of OPG and sclerostin in the blood serum. At the same time, there is an increase in IMLJ and Vps. During the correlation analysis, it was shown that the level of OPG was positively correlated with the level of sclerostin and negatively with the level of iPTG.

CONCLUSION

CONCLUSION. In our study, we obtained data confirming the interactive interaction between the vascular and bone systems. Morphogenetic proteins-inhibitors of bone metabolism (sclerostin and OPG) play a significant role in the defeat of the cardiovascular system in patients with CKD, as they promotes the development of vascular calcification.

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Nephrology Dialysis Transplantation 2020; 35, Supplement_3, gfaal 42.P0930. doi:10.1093/ndt/gfaal42.P0130Nam X Lee S, Kim HW et al. Serum levels of osteopro-tegerin are associated with obesity in chronic kidney disease. Nephrology Dialysis Transplantation 2020; 35, Supplement_3, gfaal 42.P0930. doi: 10.1093/ndt/gfaal42.P0930Delanaye P, Paquot F, Bouquegneau A et al. Sclerostin and chronic kidney disease: the assay impacts what we (thought to) know. Nephrol Dial Transplant 2018;33(8):1404—10. doi: 10.1093/ndt/gfx282Delanaye P, Paquot F, Bouquegneau A et al. Sclerostin and chronic kidney disease: the assay impacts what we (thought to) know. Nephrol Dial Transplant 2018;33(8):1404—10. doi: 10.1093/ndt/gfx282

The authors declare that there are no conflicts of interest present.