Povezanost tipa preloma kosti i stepena formiranja kalusa sa koncentracijom leptina kod dece sa prelomima dugih kostiju
Sažetak
Uvod/Cilj. Novije studije pokazuju da adipokini imaju važnu ulogu u fiziologiji i patologiji kostiju. Takođe, najnoviji podaci pokazuju da adipokin leptin funkcioniše kao regulator rasta kostiju sistemski i lokalno. Pokazano je da leptin utiče na volumen kostiju i mineralnu gustinu kostiju u populaciji sa metaboličkom i/ili hormonskom
abnormalnošću. Podaci o vrednostima leptina kod negojazne dece sa frakturama su oskudni. Metode. U ovu studiju bila su uključena 93 negojazna deteta sa prelomima dugih kostiju (LBF), 14 dece sa prelomima malih kostiju (SBF) i 19 zdrave dece. Koncentracija leptina određena je u 2 uzorka krvi (0. dana i 21. dana) i analizirana prema polu, tipu frakture, lokalizaciji anatomske frakture, topografiji frakture, formiranju kalusa i ishodu zarastanja. Rezultati. Deca sa LBF imala su značajno povećane nivoe leptina u poređenju sa kontrolnom grupom u oba uzorka krvi (0. dana/21. dana). U kontrolnoj grupi devojčice su imale značajno više nivoe leptina od dečaka. Na vrednost leptina značajno je uticala anatomska lokalizacija, jer su dečaci i devojčice sa prelomom humerusa i devojčice sa prelomom femura imali najveću prosečnu koncentraciju leptina u početnom uzorku. Dečaci sa nepotpuno formiranim kalusom imali su najveću koncentraciju leptina (u oba uzorka, 0. dana/21. dana), značajno višu u odnosu na kontrolne uzorke dečaka, uzorke dečaka s intermedijarnim i dobro formiranim kalusom, a takođe višu u odnosu na koncentracije leptina u početnim uzorcima djevojčica s nepotpunim kalusom. Bolje formiranje kalusa kod devojčica je bilo povezano sa povećanjem koncentracije leptina u drugom (21. dan) u odnosu na početni uzorak (0. dan). Devojčice sa delimično i zadovoljavajuće formiranim kalusom imale su značajno višu koncentraciju leptina u drugom uzorku (21. dan) u odnosu na grupu dečaka. Zaključak. Koncentracija leptina je značajno povećana (u oba uzorka krvi) kod dece sa LBF u poređenju sa decom sa SBF i odgovarajućim kontrolama. Koncentracija leptina je zavisna od pola. Visok nivo leptina u krvi kod dečaka ili niska koncentracija leptina kod devojčica odmah nakon preloma može se koristiti za identifikaciju grupa dece sa nepotpunim formiranjem kalusa.
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