Lviv clinical bulletin 2015, 1(9): 14-18

https://doi.org/10.25040/lkv2015.01.014

Characteristic of Calcium and Phosphorus Homeostasis and Bone Mineral Density in Children from Ecologically Polluted Regions Before and After Treatmen

N. Kech

State Institution “Institute of Hereditary Pathology of NAMS of Ukraine”, Lviv

Introduction. One of the decisive mechanisms of the influence of xenobiotics on a human organism is the disturbance of calcium-phosphorous homeostasis and oxidative metabolism of cells due to the changes in the intracellular flow of calcium (Ca) and phosphorus (P), their replacement on specific receptors, and subsequent activation of calcium-dependent enzymes and hormones. Even in the case of short hypoxia, and during the action of xenobiotics, prolonged tissue hypoxia occurs, homeostasis of such trace elements as Na+, K+, Ca++, P+++, Mg++, Mn+++, Cu++ and Fe++, that correlates with the decrease of the level of intracellular ATP and the activity of most metal enzymes.

Aim. To find out the effectiveness of advanced standard treatment of lesions of the bone system in children from ecologically disadvantaged areas (EDAs) based on the study of calcium-phosphorous homeostasis and mineral density of bone tissue.

Materials and methods. We investigated 239 children from ecologically polluted regions and 70 children from ecologically clean area. Children’s age is from 3 to 18 years, sex – 48, 0 % boys and 52, 0 % – girls. Level of calcium and phosphorus in the blood and urine in these children before and after the treatment was analyzed by the biochemistry examination. Bone mineral density and bone system degree of changes were measured by ultrasound densitometry.

Results. Level of calcium and phosphorus in the blood in observed children from polluted region was reduced. Level of calcium in the urine was increased in the majority of observed children from the radiation polluted region and in children from the chemistry polluted regions. And level of phosphorus in the urine was increased in the majority of observed children from chemistry polluted regions. The level of the bone mineral density in these children was reduced. Indicators of calcium and phosphorus content in blood and urine and bone mineral density in the examined children after a complex, individually selected treatment were normalized. Indicators of bone mineral density of children from all EDAs irrespective of the nature of contamination and ways of getting xenobiotics into the organism, have significantly decreased and are within the age range compared with the indicators of healthy children after the treatment.

Conclusions. In the majority of the examined children in radiation and chemically contaminated areas there was a significant hypocalcemia, hypophosphatemia and hypercalciuria, hyperphosphaturia, which managed to be corrected by the proposed treatment.

References

  1. Banadyha NV, Rogalskyy AI. Diagnosis and Correction of Osteopenia in Children with Asthma. Problems of Osteology. 2002;5(2-3):111-114. (Ukrainian).
  2. Zbroy LO, editor. Environment of Ivano-Frankivsk Region, art coll. Ivano-Frankivsk, 2004. 133 p. (Ukrainian).
  3. Kapustina TY, Kapranov NI. The State of the Mineral Density of Bone Tissue in Patients with Cystic Fibrosis. Pediatrics. 2008;87(5):39-41. (Russian).
  4. Loboda VF, Kinash MI. The Role of the Liver in Maintaining the Calcium-Phosphorus Homeostasis of the Body. Perinatology and Pediatrics. 2003;1:52-55. (Ukrainian).
  5. Nazarenko GI, Kiskun AA. Clinical Evaluation of the Laboratory Results. Moskow : Medicine, 2002. p. 200-203. (Russian).
  6. Korzh NA, Povorozniuk V, Deduh NV, Zupanets IA. Osteoporosis: Epidemiology, Clinics, Diagnosis, Prevention and Treatment. Kharkiv: Gold Pages, 2002. 648 p. (Ukrainian).
  7. Povorozniuk VV. Age Features of the Cancellous Bone Tissue State in the Residents of Ukraine, Ultrasound Densitometry Data. Journal of Medical Sciences of Ukraine. 1997;1:127-133. (Ukrainian).
  8. Povorozniuk VV, Grigorieva NV, Tatarchuk TF. Osteoporosis – “Silent” Epidemic. Health of Ukraine. 2006;4:61. (Ukrainian).
  9. Povorozniuk VV, Vilensky AB. Structural and Functional Status of Bone Tissue in Children and Adolescents of Ukraine According to the Data of Ultrasound Densytotherapy. Journal of Physiotherapy and Balneology. 2003;1:92-94. (Ukrainian).
  10. Povorozniuk VV. Structural and Functional Status of Bone Tissue in Children and Adolescents, According to the Data of Ultrasound Densitometry. Diseases of the Musculoskeletal System in People of All the Ages (selected lectures, reviews, articles): in 2 vol. Kyiv, 2004;1:146-152. (Ukrainian).
  11. Rakhmanov AS, Bakulyn A. Bone Densitometry in the Diagnosis of Osteopenia. Osteoporosis and Osteopathy. 1998;1:28-30. (Russian).
  12. Smiyan IS, Pohurska SO. Iron Metabolism and Bone Mineral Density in Children with Recurrent and Chronic Bronchitis. Pediatrics, Obstetrics and Gynecology. 2004;2:24-27. (Ukrainian).
  13. Povorozniuk VV, Klymovytskyy FV, Balatska NI, Povorozniuk VasV. Structural and Functional Status of Bone Tissue, Anthropometric Indices and Biological Age of Boys in North District of Donetsk Region. Trauma. 2010;11(1):5-12. (Ukrainian).
  14. The Scheme of Complex Treatment of Children with Ecopathology and Method for Monitoring of Its Effectiveness (Newsletter. N 273. 2003). Kyiv: Ukrmedpatentinform of Ministry of Health of Ukraine, 2003. 4 p. (Ukrainian).
  15. Kotov SM, Charles NA, Maksymtseva IM et al. Formation of the Skeleton in Children and Adolescents in Norm and Pathology: Guidance for Doctors. SPb., 2002. p. 6-16. (Russian).
  16. Scheplyahyna LA, Moiseev TY. Deficit of Calcium – Opportunities of Food Correction in Preschoolers. Consilium Medicum. Annex Pediatrics. 2007;1:80-83. (Russian).
  17. Afghani A, Goran MI. Racial differences in the association of subcutaneous and visceral fat on bone mineral content in prepubertal children. Calcif. Tissue Int. 2006;79(6):383-388. https://doi.org/10.1007/s00223-006-0116-1
  18. British Food Standard Agency. Expert group on vitamins and minerals. Covering note to EVM/00/11. Revised review of vitamin D, 2002. p. 1-55.
  19. Clark EM, Ness AR, Tobias JH. Adipose tissue stimulates bone growth in prepubertal children. J Clin Endocrinol Metab. 2006;91(7):2534-2541. https://doi.org/10.1210/jc.2006-0332
  20. Gueguen L. The bioavailability of dietary calcium. J Amer Coll Nutr. 2000;19(2):119-136. https://doi.org/10.1080/07315724.2000.10718083
  21. Osteodensitometry in healthy postmenopausal women. Prescrire Int. 2008;17(94):68-72.
  22. Marín F, González-Macías J, Díez-Pérez A, Palma S, Delgado-Rodríguez M. Relationship between bone quantitative ultrasound and fractures: a meta-analysis. J Bone Miner 2006;21:1126-1135. https://doi.org/10.1359/jbmr.060417
  23. Krieg MA, Barkmann R, Gonnelli S, Stewart A, Bauer DC, Del Rio Barquero L et al. Quantitative Ultrasound in the Management of Osteoporosis: The 2007 ISCD Official Positions. J Clin Densitometry: Assessment of Skeletal Health. 2008;11(1):163-187. https://doi.org/10.1016/j.jocd.2007.12.011