期刊论文详细信息
Endocrine journal
Alkaline phosphatase in pediatric patients with genu varum caused by vitamin D-deficient rickets
article
Masashi Mukai1  Toshimi Michigami2  Keiichi Ozono3  Takehisa Yamamoto1  Shinji Takeyari3  Yasuhisa Ohata3  Taichi Kitaoka3  Takuo Kubota3  Katsusuke Yamamoto4  Eri Kijima1  Yasuhiro Hasegawa1 
[1] Department of Pediatrics, Minoh City Hospital;Department of Bone and Mineral Research, Osaka Women’s and Children’s Hospital;Department of Pediatrics, Osaka University Graduate School of Medicine;Department of Pediatric Nephrology and Metabolism, Osaka Women’s and Children’s Hospital
关键词: Genu varum;    Alkaline phosphatase;    Linear mixed model analysis;    Structural equation modeling analysis;    Neural network analysis;   
DOI  :  10.1507/endocrj.EJ20-0622
学科分类:内分泌与代谢学
来源: Japan Endocrine Society
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【 摘 要 】

An elevated serum alkaline phosphatase (ALP) level is one of the markers for the presence of rickets in children, but it is also associated with bone formation. However, its role in diagnosing genu varum in pediatric patients with vitamin D-deficient rickets is still unknown. To clarify the role of the serum ALP level in assessing the severity of genu varum, we retrospectively investigated this issue statistically using data on rickets such as serum intact parathyroid hormone (iPTH), 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, ALP, the level of creatinine as the percentage of the median according to age (%Cr), and the metaphyseal diaphyseal angle (MDA) in the lower extremities as an index of the severity of genu varum. A multiple regression analysis revealed that log ALP and %Cr values were negatively associated with MDA values. The former association was also confirmed by a linear mixed model, while iPTH was positively associated with MDA by path model analysis. To elucidate the association of ALP with MDA in the presence of iPTH, we investigated three-dimensional figures by neural network analysis. This indicated the presence of a biphasic association of ALP with MDA: the first phase increases while the second decreases MDA. The latter phenomenon is considered to be associated with the increase in bone formation due to the mechanical stress loaded on the lower extremities. These findings are important and informative for pediatricians to understand the significance of the serum ALP level in pediatric patients with genu varum caused by vitamin D deficiency.

【 授权许可】

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