INDICATORS OF CALCIUM METABOLISM AND MARKERS OF BONE FORMATION IN PATIENTS WITH IDIOPATHIC SCOLIOSIS DEPENDING ON AGE

The question of the state of mineral metabolism in patients with idiopathic scoliosis, the presence of osteoporosis and its effect on formation or progression of deformity, especially in connection with the age of patients, cannot be considered conclusively resolved.

Objective. To study indicators of calcium metabolism and markers of bone formation in patients with idiopathic scoliosis depending on age.

Material and research methods. Calcium metabolism indicators (total and ionized calcium, parathyroid hormone, daily urine calcium), phosphorus, markersof bone formation (alkaline phosphatase, osteocalcin, P1NP(N - terminal procollagen type I propeptide) in the blood), morning urine DPID(deoxypyridinoline), blood level of 25 (OH) D(25-hydroxycalciferol, vitamin D) were studied before surgery in 39 patients with scoliosis (21 patients at the age not more than 18 years (group 1), and 18 patients older than 18 years (group 2). All patients were examined by x-ray and computed tomography to determine the degree of deformity.

Results. The results of the work showed that no reliable unidirectional increase was found in all (defined in this study), indicators of both bone formation and resorption. Disorders of calcium homeostasis (decreased excretion of calcium with daily urine at normal levels of calcium in the blood) was found in 20 patients. In all patients, the resorption markers of deoxypyridinoline and osteocalcin were within the reference values, while alkaline phosphatase, P1NP in the blood were high in all examined patients under the age of 18 years, in adult patients, alkaline phosphatase was within normal limits. 21 patients under the age of 18 years had a deficit of 25 (OH) D, in adult patients its deficiency was revealed.

Conclusion. Considering the literature data and our own material, we can confidently assume that mineral metabolism in patients with idiopathic scoliosis in childhood has a more high-rate type of bone remodeling than in adult patients, affecting the progression of deformity.

1. Burwell R.G., Clark E.M., Dangerfield P.H., Moulton A. Adolescent idiopathic scoliosis (AIS): a multifacto rial cascade concept for pathogenesis and embryonic origin. Scoliosis Spinal Disord. 2016. 11. 8.

2. Khotim O.A., Sychevskiy L.Z., Anosov V.S. Osteopenia as a risk factor for the development and progression of scoliosis in children. Zhurnal Grodnenskogo gosudarstvennogo meditsinskogo universiteta. 2017. 2. 176-180. in Russian.

3. Bakhtina E.N., Rodionova S.S., Kuleshov A.A., Kolesov S.V Features of bone metabolism in patients with idiopathic scoliosis (preliminary report). Osteoporoz i osteopatii. 2016. 2. 71. in Russian.

4. Goździalska A., Jaśkiewicz J., Knapik-Czajka M., Drąg J., Gawlik M., Cieśla M., Kulis A., Zarzycki D., Lipik E. Association of Calcium and Phosphate Balance,Vitamin D, PTH, and Calcitonin in Patients With Adolescent Idiopathic Scoliosis. Spine (PhilaPa1976). 2016. 41(8). 693-697.

5. Balioglu M.B., Aydin C., Kargin D., Albayrak A., Atici Y., Tas S.K., Kaygusuz M.A. VitaminD measurement in patients with adolescent idiopathic scoliosis. J Pediatr Orthop B. 2017. 26(1). 48-52.

6. Silva R.T., Fernandes R.J., Ono A.H., Marcon R.M., Cristante A.F., de Barros Filho T.E. Role of different hormones in the pathogenesis and severity of adolescent idiopathic scoliosis. Acta Ortop Bras. 2017. 25. 15-17.

7. Cheuk K.Y., Zhu T.Y., Yu F.W., Hung V.W., Lee K.M., Qin L., Cheng J.C., Lam T.P. Abnormal Bone Mechanical and Structural Properties in Adolescent Idiopathic Scoliosis: A Study with Finite Element Analysis and Structural Model Index. Calcif Tissue Int. 2015. 97(4). 343-352.

8. Wang Z.W., Lee W.Y., Lam T.P., Yip B.H., Yu F.W., Yu W.S., Zhu F., Ng B.K., Qiu Y., Cheng J.C. Defining the bone morphometry, micro-architecture and volumetric density profile in osteopenic vs non-osteopenic adolescent idiopathic scoliosis. Eur Spine J. 2017. 26(6). 1586- 1594.

9. Gaydyshev I.P. AtteStat data analysis program (64-bit OS). Available from: http://attestatsoft.narod.ru (on 29.09.2019). in Russian.

10. Jacobs D., DeMott W., Oxley D. Laboratory test handbook, Lexi-comp. 2004. 328-329.

11. Kits and equipment for clinical laboratory diagnostics. Catalog "BioChemMac". Scientific editor and consultant: Doctor of Medical Sciences, Professor I.G. Kozlov (volume I, volume II, volume III). 2007, 2009, 2014. 999. in Russian.

12. Cheung T.F., Cheuk K.Y., Yu F.W., et al. Prevalence of vitamin D insufficiency among adolescents and its correlation with bone parameters using high-resolution peripheral quantitative computed tomog raphy. Osteoporos Int. 2016. 27. 2477-88.

13. Zhu K., Oddy W.H., Holt P., et al. Tracking of vitamin D status from childhood to early adulthood and its association with peak bone mass. Am J Clin Nutr. 2017. 106. 276-83.

14. Tam E.M., Yu F.W., Hung V.W., et al. Are volumetric bone mineral density and bone microarchitecture associated with leptin and soluble leptin receptor levels in adolescent idiopathic scoliosis?: a case-control study. PLoS One. 2014. 9. e87939.

15. Chinda D., Shimoyama T., Iino C., Matsuzaka M., Nakaji S., Fukuda S. Decrease of estradiol and several lifestyle factors, but not helicobacter pylori infec tion, are significant risks for osteopenia in Japanese females. Digestion. 2017. 96. 103-109.

16. Nurullina G.M., Akhmadullina G.I. Bone remodeling in health and in primary osteoporosis: the significance of markers of bone remodeling. Arkhiv" vnutrenney meditsiny. 2018. 8(2): 100- 110. in Russian.

17. Begon M., Scherrer S.A., Coillard C., Rivard C.H., Allard P. Three-dimensional vertebral wedging and pelvic asymmetries in the early stages of adolescent idiopathic scoliosis. Spine J. 2015. 15. 477-486.

18. Ishida K., Aota Y., Mitsugi N., Katsuhata T., Higashi T., Yamada K., Saito T. Bone metabolism and bone mineral density in adolescent idiopathic scoliosis. Scoliosis. 2015. 10(Suppl 1). P7.

19. Ishida K., Aota Y., Mitsugi N., Kono M., Higashi T., Kawai T., Yamada K., Niimura T., Kaneko K., Tanabe H., Ito Y., Katsuhata T., Saito T. Relationship between bone density and bone metabolism in adolescent idiopathic scoliosis. Scoliosis. 2015. 10. 9 DOI 10.1186/s13013-015-0033-z

20. Kokushin D.N., Filippova A.N., Khusainov N.O. Some factors in the progression of idiopathic scoliosis. Sovremennye problemy nauki i obrazovaniya. 2017. 5. Available from: http://www.science-education.ru/ru/article/view?id=26834 (on 24.06.2019). in Russian.