慢性維持透析患者における血漿中遊離γ-カルボキシグルタミン酸に関する研究

Abstract

The clinicopathological future of renal osteodystrophy (ROD) associated with patients of long-term hemodialysis is well known to be very complicated. In the diagnosis of ROD and the monitoring of its clinical course, several biochemical parameters have been appreciated as the most useful indicators. Among these parameters, the current clinical investigation proved that bone gla protein (BGP) which contained three γ-glutamic acid residues per one molecule, was one of the most sensitive parameters of ROD. Based upon this background, we assayed free-γ-carboxyglutamic acid (free-γ Gla) in plasma in 36 patients with long-term hemodialysis and compared these values with other parameters of ROD. In conclusion plasma free-γ Gla levels of hemodialysis patients indicated significantly higher than those of controls (P＜0.0001). And evident correlations were found between plasma free-γ Gla and serum PTH-C (r=0.46, P＜0.01), serum PTH-M (r=0.64, P＜0.01), serum intact PTH (r=0.40, P＜0.05), serum ALP (r=0.44, P＜0.01), serum ALP Ⅲ (r=0.71, P＜0.01), serum TRACP (r=0.40, P＜0.05), serum Hydroxyproline (r=0.36, P＜0.05) and serum BGP (r=0.50, P＜0.01). On the other hand plasma free-γ Gla and each parameter of digital image proccessing method (MCI and Σ GS/D) have not shown evident correlation. These results suggest that plasma free-γ Gla is one of the most important parameters of ROD in chronic maintenance hemodialysis patients.