Objectives To estimate parameters of calcium-phosphorus metabolism depending on the presence of osteoporosis in patients with chronic ischemic heart disease.
Methods The study included 66 male patients with documented coronary heart disease and coronary artery calcification. Average age: 59.8 (55; 70) years. Tacna bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry at densitometere on bone mineral density (g/cm3) and indicators of T-score at the femoral neck and lumbar spine (vertebral bodies LI-LIV). To determine the level of markers calcium and phosphorus metabolism served as serum or plasma of patients. The method of enzyme-linked immunosorbent assay, the concentration of the following analytes: parathyroid hormone, calcitonin, osteocalcin, the bone isoenzyme of alkaline phosphatase, osteoprotegerin, osteopontin, cathepsin K.
Results BMD of the evaluation of all patients divided into two groups: The first group includes patients with normal density (T-score of 2.5 to -1,0) (n=12, 20%), the second - patients osteoporosis and osteopenia (T-score of -1.1 or less) (n=53, 80%). That is, in the majority of patients with documented coronary heart disease and coronary artery calcification revealed various degrees of osteopenic syndrome. The evaluation of biomarkers calcium and phosphorus metabolism revealed a significant decrease in the level of osteocalcin in patients with coronary artery disease and osteopenic syndrome (17.51 [12.83; 22.13] ng/ml) compared with patients with normal densitometry (11.37 [8.03; 16.14] ng/ml, p<0.05), which reflects the severity of osteoporosis in these patients. A decreased content of osteopontin in patients with osteopenic syndrome (6.42 [5.44; 7.16] ng/ml) compared with patients with normal bone density, lint (6.84 [6.07; 7.50] ng/ml, p<0.05). This may be due to the known association of this parameter with the severity of atherosclerosis, but in the present study found a significant decrease when it osteopenic syndrome, which may be due to its protective effect against ostorezorbtsii. Also showed a reduction in the level of cathepsin K in patients with osteopenic syndrome (12.41 [0.01; 23.15] pmol/L) compared with patients with normal bone density (23.59 [0.01; 36.55] pmol/L, p<0.05), which can be attributed to the intracellular activity of this peptide in the development of bone resorption, lint. According to other indicators calcium and phosphorus metabolism significant differences between the groups of patients were identified.
Conclusions The high frequency of osteopenia, detectable by densitometry male patients with coronary heart disease and coronary artery calcification. In patients with osteopenic syndrome also showed low levels of indicators characterizing the calcium and phosphorus metabolism: osteocalcin, osteopontin and cathepsin K, which may also affect the severity of coronary artery calcification.
Disclosure of Interest None declared