Özlem ÖZTÜRK, Ali GÜÇTEKİN, Zeynep GENİŞ, Serpil ERDOĞAN

Hipertiroidi ve subklinik hipertiroidide kemik ve mineral metabolizmasının idrar piridinyum çapraz bağlarıyla değerlendirilmesi

Amaç: Hipertiroidili ve subklinik hipertiroidili hastalarda kemik turnover’ının idrar piridinolin, deoksipiridinolin ve serum kemik spesifik alkalen fosfataz (ALP) düzeyleriyle değerlendirilmesi. Yöntem: Hipertiroidili gruba 33 hasta, subklinik hipertiroidili gruba 15 hasta alındı. Kontrol grubu 30 sağlıklı kişiden oluşuyordu. Hasta ve kontrollerde kemik turnover’ı, idrar piridinolin (Pyd), deoksipiridinolin (Dpd) ve serum kemik spesifik ALP düzeyleri ile karşılaştırıldı. ROC eğrisi kullanılarak hastalarda kemik turnover artışını göstermede Pyd, Dpd ve BALP düzeylerinin anlamlılık derecelerine bakıldı. Bulgular: Serum Ca, İdrar Ca/Cre, serum ALP ve BALP sadece hipertiroidili grupta anlamlı artış gösteriyordu. İdrar Pyd ve Dpd ise her iki grupta da kontrol grubuna göre anlamlı olarak artmıştı. Hipertiroidili hastalarda sT3 ve sT4 değerleriyle Dpd ve Pyd arasında anlamlı pozitif korelasyon vardı. Hastalarda ROC eğrisi kullanılarak eğri altındaki alanlara göre Dpd, Pyd, BALP’in kemik turnover artışını tanımada anlamlı oldukları gözlendi. Sonuç: Hipertiroidililerde Dpd, Pyd, BALP, idrar Ca/Cre kemik turnover durumunu yansıtmada kullanılabilir. Subklinik hipertiroidili hastalarda ise idrar Dpd ve Pyd düzeylerinde anlamlı artış olması subklinik hipertiroidide de kemik turnover’ının artmış olabileceğini düşündürmüştür.

The assessment of bone and mineral metabolism with urine pyridinium cross links in hyperthyrodism and subclinical hyperthyroidism

Objective: The evaluation of bone turnover with urine pyridinoline, deoxypyridinoline and serum bone spesific alkaline phosphatase (ALP) in hyperthyroid and subclinical hyperthyroid patients. Methods: 33 patients to hyperthyroid group and 15 patients to subclinical hyperthyroid group were taken. Control group was consisted of 30 healthy participants. Bone turnover in patients and control groups were compared with each other by using urine pyridinoline (Pyd), deoxypyridinoline (Dpd) and serum bone specific alkaline phosphatase (BALP). In patients groups for mentioning the increase of bone turnover; Pyd, Dpd and BALP levels' degrees of significancies were evaluated by using ROC curves. Results: Serum Ca, urine Ca/Cre, ALP and BALP ratios were significantly higher only in the hyperthyroid group. But urine Dpd and Pyd concentrations were observed significantly higher in both patient groups. There were significant positive correlations between serum sT3, sT4 and Dpd, Pyd in hyperthroid group. In patients by using the areas under the ROC curves, it is observed that Dpd, Pyd and BALP were important for mentioning the increase of bone turnover. Conclusions: Dpd, Pyd, BALP, urine Ca/Cre ratios can be used for reflecting bone turnover balance in hyperthyroid patients. But in subclinical hyperthroid patients, the significant increases of urine Dpd and Pyd preoccupied that bone turnover can be risen in subclinical hyperthroidy too.

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