ABSTRACT
Introducción: la Hipercalciuria Idiopática (HI), entidad considerada tradicionalmente benigna y asociada a hematuria o urolitiasis, es uno de los trastornos del metabolismo de calcio y fósforo más frecuente en pediatría. En los últimos años se ha asociado a desmineralización ósea tanto en niños como en adultos. Objetivo: determinar el impacto de la Hipercalciuria Idiopática en el contenido mineral óseo en pacientes pediátricos chilenos. Métodos: estudio de corte transversal; se evaluaron 11 pacientes portadores de Hipercalciuria Idiopática. Se midió calcio en orina de 24 horas y en muestra aislada, calcemia, fosfemia, electrolitos plasmáticos, paratohormona plasmática (PTH) y densitometría ósea (DEXA) de columna lumbar y fémur. Para definir la relación entre la calciuria y las demás variables se utilizó un análisis de correlación simple para variables continuas. Se consideró estadísticamente significativo un p < 0,05. Resultados: se estudiaron 11 pacientes, 6 varones, 8,2 ± 2,7 años. El promedio de calcio en orina 24 h fue 9,1 ± 1,37 mg/kg/día, PTH 40 ± 15 pg/ml y el DEXA columna lumbar (Z score) fue de y -2,1 ± 0,29. El análisis estadístico mostró una correlación negativa entre calciuria de 24 h y densidad mineral ósea de columna lumbar (p < 0,05, r = -0,65), y entre Hipercalciuria vs niveles de PTH (p < 0,05, r = -0,58). Conclusión: la Hipercalciuria Idiopática en pediatría representa un riesgo de compromiso óseo que debe ser considerado al evaluar el manejo de cada paciente.
Subject(s)
Adolescent , Male , Humans , Female , Child, Preschool , Child , Bone Density , Calcium/urine , Bone Demineralization, Pathologic/etiology , Hypercalcemia/urine , Chile , Calcium/metabolism , Creatinine/urine , Bone Demineralization, Pathologic/metabolism , Hypercalcemia/complications , Hypercalcemia/epidemiology , Parathyroid Hormone/metabolism , Lumbar VertebraeABSTRACT
Background: A low calcium intake is considered a risk factor for osteoporosis. Aim: To measure calcium intake and its relationship to bone mineral density in postmenopausal women and to assess the long term changes in bone mineral density after calcium supplementation. Patients and methods: in 80 postmenopausal women older than 41 years of age, calcium intake was assessed using dietary inquires and bone mineral density was measured using a double beam radiological densitometer. Twenty-four ramdomly selected women received a daily calcium supplementation of 500 mg during five years and their bone mineral density was measured at 1,3 and 5 years. Results: Initial calcium intake was 745±37mg/day, and it did not change in the 5 years follow up. There was no relationship between bone mineral density and calcium intake. In supplemented women, bone density did not change significantly at year one. At year three, a significant reduction was observed in the spine (-4.2 percent), Wards triangle (-4 percent) and whole body mineral content(-1.14 percent). At year five, there was a significant increase in bone density at the spine femoral neck and Wards triangle as compared with year three, but not with baseline measurements. No significant differences after supplementation were observed between women with initial calcium intake of less than 500 mg/day or over this value. Conclusions: Calcium intake in urban Chilean postmenopausal women is below recommendations and stable over time. Calcium intake and bone mineral density after the meinopause are not correlated. A 500 mg/day calcium supplementation during 5 years is associated with a late reversal of the postmenopausal bone-losing trend