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Bone remodeling markers as lithogenic risk factors in patients with osteopenia–osteoporosis

  • Urology - Original Paper
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Abstract

Purpose

To analyze the presence of phosphocalcic metabolism disorders in patients with osteopenia–osteoporosis without nephrolithiasis with respect to a control group.

Methods

A cross-sectional study was conducted in patients with osteopenia–osteoporosis without nephrolithiasis (n = 67) in lumbar spine or femur and in a control group (n = 61) with no lithiasis or bone disorders. Blood bone markers, phosphocalcic metabolism, fasting urine, 24-h urine lithogenic risk factors, and densitometry were recorded in both groups. SPSS 20.0 was used for statistical analysis.

Results

In comparison with the controls, significantly higher blood calcium (9.27 ± 0.36 vs. 9.57 ± 0.38, p = 0.0001), intact parathormone (45.6 ± 14.9 vs. 53.8 ± 18.9, p = 0.008), and alkaline phosphatase (61.9 ± 20.9 vs. 70.74 ± 18.9, p = 0.014) levels were found in patients with osteopenia–osteoporosis. In the 24-h urine test, citrate (1010.7 ± 647.8 vs. 617.6 ± 315.8, p = 0.0001) and oxalate (28.21 ± 17.65 vs. 22.11 ± 16.49, p = 0.045) levels were significantly lower in osteopenia–osteoporosis patients than in controls, with no significant difference in calcium (187.3 ± 106.9 vs. 207.06 ± 98.12, p = 0.27) or uric acid (540.7 ± 186.2 vs. 511.9 ± 167.06, p = 0.35) levels. Patients with osteopenia–osteoporosis had significantly higher levels of lithogenic risk factors associated with bone remodeling, including significantly increased β-crosslaps and osteocalcin values and higher β-crosslaps/osteocalcin ratios.

Conclusion

Patients with osteopenia–osteoporosis without nephrolithiasis showed phosphocalcic metabolism disorders as well as lower urinary citrate and higher β-crosslaps/osteocalcin and fasting calcium/creatinine ratios, which would increase the risk of nephrolithiasis. Hence, prospective studies are warranted to evaluate the long-term risks.

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Acknowledgments

This article is a part of doctoral thesis of Maria Sierra Girón-Prieto. Doctorado Medicina Clinica y Salud Publica. This investigation has been founded by Fundacion Progreso y Salud. Consejeria de Salud. Junta de Andalucia. Pi 0766/2013.

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Correspondence to Miguel Ángel Arrabal-Polo.

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The authors declare no conflict of interest.

Ethical statement

It is a low ethically responsible study in which the patients gave their informed consent after reading the Patient Information Sheet. The study was approved by the Hospital Ethics Committee.

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Girón-Prieto, M.S., Arias-Santiago, S., del Carmen Cano-García, M. et al. Bone remodeling markers as lithogenic risk factors in patients with osteopenia–osteoporosis. Int Urol Nephrol 48, 1777–1781 (2016). https://doi.org/10.1007/s11255-016-1361-5

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  • DOI: https://doi.org/10.1007/s11255-016-1361-5

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