Postmenopozal Osteoporoz ve Osteopenide Plazma Homosistein Düzeyleri ile Biyokimyasal Kemik Döngüsü Belirteçleri Aras›ndaki ilişki

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Uçar Ü., Samancı Karaman N.

TURK OSTEOPOROZ DERGISI-TURKISH JOURNAL OF OSTEOPOROSIS, vol.12, pp.22-26, 2006 (Peer-Reviewed Journal)

Abstract

The present stduy was planned to investigate the relations of bone mineral density and biochemical markers of bone turnover with plasma levels of homocysteine, vitamin B12 and folate in postmenaposal women. The study was performed in 148 osteoporotic and 75 osteopenic postmenopausal patients. Control group included 61 agematched healthy postmenopausal women with normal bone mineral density. Plasma homocysteine, serum vitamin B12, folate levels, biochemical markers of bone formation and resorption and lomber vertebra (L2-L4) bone mineral density were determined in study groups. In osteoporotic group, plasma homocysteine levels and both serum and urine markers of bone resorption were found to be increased and, vitamin B12 levels which were found to be significantly decreased had a significant correlation with osteocalcin levels. Althought less marked, similar findings were obtained in osteopenic group, as well. In summary, it was concluded that the reduction in vitamin-B12 levels in osteoporotic postmenaposal women may cause negative effects on bone tissue both by increasing bone resorption indirectly through an increment in homocysteine levels and by a reduction in the direct stimulatory effect of vitamin-B12 on osteoblast and may contribute to development of osteoporosis by shifting the balance between bone formation and resorption in favor of the latter. Therefore, it was suggested that determination of plasma homocysteine and vitamin B12 levels and vitamin B12 supplementation in deficient cases might be useful in treatment of osteoporosis. (Osteoporoz Dünyas›ndan 2006; 12 (2): 22-26) Key words: Plasma homocysteine levels, biochemical markers

Bu çal›flma postmenopozal kad›nlarda plazma homosistein, vitamin-B12 ve folat düzeyleri ile kemik mineral yo¤unlu¤u ve biyokimyasal kemik döngüsü belirteçleri aras›ndaki iliflkileri araflt›rmak amac›yla planland›. Çal›flma postmenopozal osteoporozlu 148 ve osteopenili 75 hastada gerçeklefltirildi. Kontrol grubu kemik mineral yo¤unlu¤u normal olan benzer yafltaki sa¤l›kl› 61 postmenapozal kad›ndan oluflturuldu. Çal›flma gruplar›nda plazma homosistein, serum vitamin-B12, folat düzeyleri, biyokimyasal kemik yap›m ve kemik y›k›m belirteçleri ve lomber vertebra (L2-4) kemik mineral yo¤unlu¤u ölçüldü. Osteoporozlu grupta plazma homosistein ve ayr›ca serum ve idrar kemik y›k›m belirteçlerinin artm›fl oldu¤u saptand›. Ayr›ca bu hastalarda vitamin-B12 düzeylerinin azald›¤› ve osteokalsin düzeyleri ile anlaml› bir korelasyon gösterdi¤i tespit edildi. Osteoporozlu gruptaki kadar belirgin olmasa da osteopenili grupta da benzer bulgular saptand›. Sonuç olarak postmenopozal osteoporozlu kad›nlarda vit-B12 düzeylerindeki azalman›n hem homosistein düzeylerini artt›rarak indirekt olarak kemik y›k›m›n› artt›rarak hem de vitamin-B12'nin osteoblastlar üzerindeki direkt stimülan etkisinin azalmas› sonucu kemik dokusu üzerinde olumsuz etkilere neden olabilece¤i ve kemik yap›m-y›k›m dengesini y›k›m yönüne kayd›rarak osteoporoz geliflimine katk›da bulunabilece¤i kan›s›na var›ld›. Dolay›s›yla osteoporozlu hastalarda plazma homosistein ve vitamin-B12 düzeylerinin saptanmas›n›n ve gerekti¤inde vitamin-B12 destek tedavisi uygulanmas›n›n osteoporoz tedavisinde yararl› olabilece¤i düflünüldü. (Osteoporoz Dünyas›ndan 2006; 12 (2): 22-26) Anahtar kelimeler: Plazma homosistein düzeyleri, biyokimyasal kemik döngüsü belirteçleri