Abstract OBJECTIVE: To observe serum osteoprotegerin (OPG) level in children with nephrotic syndrome (NS) and changes in serum OPG level after glucocorticoid therapy, with the aim of studying the role of OPG in the bone metabolism of children with NS. METHODS: Forty-four children with idiopathic NS were randomly selected as the study group, including 24 newly diagnosed, untreated patients and 20 who had relapsed during the process of glucocorticoid reduction (cumulative dose of glucocorticoid 28327±5879 mg/m2). Twenty-three age- and sex-matched healthy children served as the control group.Serum osteoprotegerin (OPG) level was measured using ELISA. Serum N-terminal midfragment of osteocalcin (N-MID osteocalcin) was determined using electrochemical luminescence immunoassays (ECLIA). RESULTS: Serum levels of OPG (211±55 ng/L) and N-MID osteocalcin (46±14 ng/mL) in the untreated NS group were reduced compared with 470±57 ng/L (OPG) and 73±9 ng/ml (N-MID osteocalcin) in the control group (P<0.05). Serum levels of OPG (176±42 ng/L) and N-MID osteocalcin (29±10 ng/mL) in the NS relapsed group were lower than in the untreated NS and control groups (P<0.05). CONCLUSIONS: Bone metabolism disorders are found in children with NS. High-doses of glucocorticoid therapy can aggravate these disorders. Serum OPG levels in children with NS may be affected by both the renal disease itself and steroid therapy, suggesting that OPG is expected to become a new biochemical indicator for predicting changes to the bone metabolism of children with NS.
LI Yu-Liu,WANG Hua. Serum osteoprotegerin level in children with nephrotic syndrome and the effect of glucocorticoid on it[J]. 中国当代儿科杂志, 2012, 14(09): 653-656.
LI Yu-Liu,WANG Hua. Serum osteoprotegerin level in children with nephrotic syndrome and the effect of glucocorticoid on it[J]. CJCP, 2012, 14(09): 653-656.
［3］Simonet WS, Lacey DL, Cunstan CR, Kelley M, Chang MS, Lüthy R, et al. Osteoprotege: a novel secreted protein involved in the regulation of bone density ［J］.Cell,1997, 89(2): 309-319.
［4］Yasuda H. Bone and bone related biochemical examinations. Bone and collagen related metabolites. Receptor activator of NF-kappaB ligand(RANKL)［J］. Clin Calcium, 2006 16(6): 964-970.
［6］Sasaki N, Kusano E, Ando Y, Nemoto J, Iimura O, Ito C, et al. Changes in osteoprotegerin and markers of bone metabolism during glucocorticoid treatment in patients with chronic glomerulonephritis［J］. Bone, 2002, 30(6): 853-858.
［9］Delmas PD, Christiansen C, Mann KG, Price PA, Bone gla protein (osteocalcin) assay standradization report［J］. J Bone Miner Res, 1990, 5(1): 5-11.
［10］Sierra RI, Specker BL, Jiménez F, Cruz C, Pedraza-Chaverrí J. Biochemical bone markers, bone mineral content, and bone mineral density in rats with experimental nephrotic syndrome［J］. Ren Fail, 1997, 19(3): 409-424.
［11］Hofbauer LC, Gori F, Riggs BL, Lacey DL, Dunstan CR, Spelsberg TC, et al. Stimulation of osteoprotegerin ligand and inhibition of osteoprotegerin production by glucocorticoids in human osteoblastic lineage cells: potential paracrine mechanisms of glucocorticoidinduced osteoporosis［J］. Endocrinology, 1999, 140(10): 4382-4389.
［12］Vidal NO, Br-ndstrom H, Jonsson KB, Ohlsson C. Osteoprotegerin mRNA is expressed in primary human osteoblast-like cells: down-regulation by glucocorticoids［J］. J Endocrinol, 1998, 159(1): 191-195.
