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HEMODİYALİZ HASTALARİNDA SERUM OSTEOKALSIN DÜZEYİYLE ALBÜMIN ARASıNDAKI İLİŞKİ

THE RELATIONSHIP BETWEEN SERUM OSTEOCALCIN AND ALBUMIN LEVELS IN HEMODIALYSIS PATIENTS

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Abstract (2. Language): 
Purpose: Serum albumine levels frequently use to determine the nutritional aspect in hemodialysis patients. Osteocalcin is a protein which synthesized by osteoblastic cells and sensitive marker of bone formation. Relationship between osteocalcin and malnutrition has not been described completely. Previous study on children with protein energy malnutrition (PEM) and Kwashiorcor showed that decreased serum osteocalcin concentrations (5,6). For this reason in this study we planned to examine the association between serum osteocalcin levels with albumin and others nutritional markers in hemodialysis patients. Material and Method: 155 patients were included in our study (mean age: 46.1 ±17.0 years, mean duration of dialysis time: 37.2±32.3months). According to serum albumin levels patients were divided into two groups. Patients whose albumin levels were less than 3,5 g/dL (n=45) were included in Group I, whereas patients whose albumin levels were equal to higher than 3,5 g/dL (n=110) were included in Group 11. All of the patients' body mass index (BMI), triceps skin fold thickness (TSFT) and biochemical parameters such as serum blood urea nitrogen (BUN), creatinine, potassium, calcium, phosphorus, total cholesterol, hemoglobin, transferrin, alkaline phosphatase (ALP), intact parathyroid hormone (iPTH), osteocalcin (OC), and C-reactiveprotein (CRP) levels were measured. Results:ln group I patients were older than Group II and BMI, serum Hb, BUN, creatinine, potasyum, calcium and, phosphorus levels were less than Group 11. Serum OC levels were significantly lower in Group I patients than Group II. Additionally, serum OC levels were found to be positively correlated with iPTH and ALP Conclusion: In conclusion, in dialysis patients serum osteocalcin level is effected with uremic bone disease and it is found strongly associated with only albumin not others nutritional parameters so that it is used to be a determine of malnutrition need to more advantage studies.
Abstract (Original Language): 
Amaç: Serum albümin düzeyi hemodiyaliz hastalarında beslenmeyi değerlendirmede sık kullanılan bir parametredir. Osteokalsin (OS) kemikteki osteoblastlardan sentezlenen bir proteindir ve kemik oluşumunun duyarlı bir belirleyicisidir. Osteokalsinle malnutrisyon arasındaki ilişki tam olarak tanımlanmamıştır. Yapılmış çalışmalarda protein enerji malnutrisyonlu ve Kwashikor'lu çocuklarda serum osteokalsin düzeyi düşük bulunmuştur. Bu nedenle bu çalışmada hemodiyaliz hastalarında serum osteokalsin düzeyiyle malnuthsyonun önemli bir göstergesi olan serum albümin ve diğer nutrisyon parametreleri arasındaki ilişkinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmamıza 155 hasta ( yaş ortalaması 46.1 ±17.0 yıl, ortalama hemodiyaliz süresi 37.2+32.3 ay) dahil edildi. Serum albümin düzeyine göre hastalar iki gruba ayrıldı: Grup I serum albümin düzeyi <3,5g/dl ve Grup 11 serum albümin düzeyi3 3,5 g/dl. Her iki grupta vücut kitle indeksi (VKİ), triseps cilt katlantı kalınlığı, ile birlikte biyokimyasal parametre olarak: kan üre nitrojeni (BUN) kreatinin, hemoglobin (Hb), fosfor, kalsiyum, potasyum, total kolesterol, trigliserid, transferin, osteokalsin (OS), alkalen fosfataz (ALP), intakt parathormon (iPTH), ve C reaktif protein (CRP) düzeyleri ölçüldü. Bulgular: Grup /' de yaş, VKİ, Hb, BUN, kreatinin, potasyum, kalsiyum, fosfor, transferin, ve OS düzeyleri Grup W den daha düşük bulundu. Serum OS düzeyi malnutrisyon parametrelerinden sadece albüminle korelasyon gösterdi. Aynı zamanda OS iPTH ve ALP ile positive korelasyon gösterdi. Sonuç:Sonuç olarak diyaliz hastalarında OS üreınik kemik hastalığından etkilendiğinden ve malnutrisyon parametrelerinden sadece albüminle güçlü ilişkili bulunduğundan bir nutrisyon parametresi olarak kullanılabilirliği için daha ileri çalışmalara ihtiyaç vardır.
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REFERENCES

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