nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2011-15-3-35-39nefr-509Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSНЕКАРБОКСИЛИРОВАННЫЙ ОСТЕОКАЛЬЦИН У ЖЕНЩИН В ПОСТМЕНОПАУЗЕ, ПОЛУЧАЮЩИХ ЛЕЧЕНИЕ ГЕМОДИАЛИЗОМUNDERCARBOXYLATED OSTEOCALCIN IN POSTMENOPAUSAL PATIENTS ON HEMODIALYSISЖЕЛЯЗКОВА-САВОВАМ. Д.ZHELYAZKOVA-SAVOVAM. D.

Кафедра доклинической и клинической фармакологии и токсикологии

ГАЛУНСКАБ. Т.GALUNSKAB. Tz.

кафедра биохимии, молекулярной медицины и нутригеномики

ГЕРОВАД. И.GEROVAD. I.ЧЕРВЕНКОВТ. Г.CHERVENKOVT. G.

лаборатория клинической иммунологии

СИДЕРОВАМ. В.SIDEROVAM. V.ЗОРЧЕВАР. Ж.ZORCHEVAR. J.ПАСКАЛЕВД. Н.PASKALEVD. N.Центр клинической лабораторной диагностики госпиталя Св. МаринаBulgariaгоспиталь Св. МаринаRussian FederationКлиника эндокринологии госпиталя Св. МаринаRussian FederationКлиника нефрологии и диализа госпиталя Св. Марина Медицинского университетаRussian Federation2011100320111533539Copyright © ЖЕЛЯЗКОВА-САВОВА М.Д., ГАЛУНСКА Б.Т., ГЕРОВА Д.И., ЧЕРВЕНКОВ Т.Г., СИДЕРОВА М.В., ЗОРЧЕВА Р.Ж., ПАСКАЛЕВ Д.Н., 20112011ЖЕЛЯЗКОВА-САВОВА М.Д., ГАЛУНСКА Б.Т., ГЕРОВА Д.И., ЧЕРВЕНКОВ Т.Г., СИДЕРОВА М.В., ЗОРЧЕВА Р.Ж., ПАСКАЛЕВ Д.Н.ZHELYAZKOVA-SAVOVA M.D., GALUNSKA B.T., GEROVA D.I., CHERVENKOV T.G., SIDEROVA M.V., ZORCHEVA R.J., PASKALEV D.N.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/509

Остеокальцин - витамин К-зависимый белок, секретируемый остеобластами. При дефиците витамина К отмечается повышение концентрации неактивной его фракции - некарбоксилированного остеокальцина (Глю-ОК). Хроническая болезнь почек ассоциируется с остеопорозом, а также субоптимальным статусом витамина К. ЦЕЛЬЮ данного исследования было оценить статус витамина К у женщин в периоде постменопаузы, получающих лечение гемодиализом с учетом уровня Глю-ОК, основываясь на идее о необходимости заместительной терапии витамином К. ПАЦИЕНТЫ И МЕТОДЫ. 78 женщин в постменопаузе были распределены на 3 группы: 1-я - женщины, получающие лечение гемодиализом; 2-я - контрольная группа с нормальной минеральной плотностью костей; 3-я группа с остеопорозом. Концентрацию Глю-ОК определяли иммунохимическим методом. Остеопороз верифицировали по результатам двухэнергетической рентгеновской абсорб-циометрии лучевой кости. РЕЗУЛЬТАТЫ. Концентрация сывороточного Глю-ОК у гемодиализных пациенток была значимо повышена по сравнению с группой контроля и группой остеопороза при отсутствии значимых различий между двумя последними. У гемодиализных больных была выявлена достоверная положительная взаимосвязь между Глю-ОК и концентрацией паратгормона, а также между Глю-ОК и длительностью гемодиализа. ЗАКЛЮЧЕНИЕ. Повышение концентрации Глю-ОК у женщин в постменопаузе, получающих лечение гемодиализом, может свидетельствовать о тяжелом дефиците витамина К, однако возможно влияние и других факторов. Следовательно, необходимы дополнительные исследования для подтверждения необходимости заместительной терапии витамином К у данной категории больных.

Osteocalcin is a vitamin K-dependent protein secreted by osteoblasts. In vitamin K deficiency the fraction of the inactive, undercarboxylated osteocalcin (ucOC) is increased. Chronic kidney disease is associated with bone loss and there is evidence for a sub-optimal status of vitamin K in renal patients. THE AIM of the present study was to assess the vitamin K status in postmenopausal hemodialysis patients based on their ucOC level with the background idea to substantiate the need of vitamin K supplementation. PATIENTS AND METHODS. 78 postmenopause women were divided into 3 groups: 1) women on hemodialysis; 2) a control group with normal bone mineral density; 3) osteoporosis group. Serum ucOC was measured immunochemically. Osteoporosis was verified by DEXA scan of the radius. RESULTS. Serum ucOC in hemodialysis women was significantly increased in comparison with control and osteoporosis group, which did not differ significantly between each other. In hemodialysis patients, a strong positive correlation was found between ucOC and parathormone and between ucOC and hemodialysis duration. CONCLUSION. The increase of ucOC in hemodialysis postmenopausal patients may indicate a severe vitamin K deficit, but other factors may also contribute. Therefore, additional investigation is needed to justify supplementation with vitamin K in these patients.

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