Markeri koštanog metabolizma u medikamentnoj i fiziološkoj hiperprolaktinemiji kod ženki pacova
Sažetak
Uvod/Cilj. Nema dovoljno podataka o efektima prolaktina na metabolizam kalcijuma i koštani promet kod hiperprolaktinemije različitog porekla. Cilj ovog rada bio je da uporedi uticaj medikamentne i fiziološke hiperprolaktinemije na koštani metabolizam kod ženki pacova. Metode. Eksperimentalne životinje (ženke pacova soja Wistar, stare 18 nedelja) podeljene su na sledeće grupe: grupa P – devet pacova u trećoj nedelji trudnoće; grupa M3 – 10 pacova, kojima je tokom tri nedelje, dva puta dnevno, davan intramuskularno sulpirid (10 mg/kg); grupa M6 – 10 pacova kojima je tokom šest nedelja, davan sulpirid (10 mg/kg) intramuskularno, dva puta dnevno; starosno odgovarajuće nulipare ženke pacova kao kontrolne grupe: C1 – 10 pacova, starih 18 nedelja i C2 – sedam pacova, starih 24 nedelje. Određivana je koncentracija jonizovanog kalcijuma i fosfora u serumu, 24-časovno izlučivanje kalcijuma i fosfora urinom, osteokalcin i serumski amino terminalni propeptid prokolagena tipa I (P1NP). Rezultati. U poređenju sa kontrolnom grupom eksperimentalne životinje u grupi P imale su snižen jonizovan kalcijum u serumu (0,5 ± 0,2 vs 1,12 ± 0,04 mmol/L; p < 0,001), povišene fosfate u serumu (2,42 ± 0,46 vs 2,05 ± 0,2mmol/L; p < 0,05), povećano 24-časovno izlučivanje kalcijuma urinom (3,90 ± 0,46 vs 3,05 ± 0,58 mmol/24 h; p < 0,01) i značajno povišen P1NP (489,22 ± 46,77 vs 361,9 ± 53,01 pg/mL; p < 0,001). Značajan pad P1NP zabeležen je u eksperimentalnoj grupi M3 u poređenju sa kontrolnom grupom. Prolongirana medikamentna hiperprolaktinemija u grupi M6 dovela je do porasta jonizovanog kalcijuma u serumu (1,21 ± 0,03 vs 1,15 ± 0,02mmol/L; p < 0,001), pada fosfata (1,70 ± 0,13 vs 1,89 ± 0,32 mmol/L; p < 0,001) i sniženja koncentracije osteokalcina i P1NP. Zaključak. Fiziološka hiperprolaktinemija u manjoj meri utiče na koštani metabolizam nego medikamentna hiperprolaktinemija. Hronična medikamentna hiperprolaktinemija dovodi do pada koncentracije P1NP, što je odraz snižene koštane formacije. Rutinsko određivanje biohemijskih markera koštanog metabolizma u prolongiranoj medikamentnoj hiperprolaktinemiji pruža mogućnost ranije dijagnoze poremećaja koštanog metabolizma.
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