Valores de calcio y de los marcadores bioquímicos de remodelamiento óseo en el momento del parto | Clínica e Investigación en Ginecología y Obstetricia

Información del artículo

Resumen

Introducción

Durante el parto se producen dos situaciones que pueden afectar al metabolismo fosfocálcico como son las contracciones uterinas y el desprendimiento placentario. Ambos hechos suponen alteraciones que pueden modificar los valores de los marcadores de remodelamiento óseo.

PacientesyméTODO

Se determinan los niveles de calcio,fósforo,albúmina,parathormona,fosfatasa alcalina total y osteocalcina séricas,y de piridinolinas y su ratio con la creatinina en la orina,en 38 embarazadas normales en el momento del parto.

Resultados

El calcio total presenta valores significativamente inferiores a los observados durante el embarazo (p < 0,01),mientras que la albúmina,la fosfatasa alcalina,la parathormona y la osteocalcina no presentan diferencias significativas. Las piridinolinas urinarias presentan,de forma aislada,unos valores elevados,aunque se normalizan si se analizan en relación con la creatinina.

Discusión

Las modificaciones de los marcadores de remodelamiento óseo durante el parto son producto más del propio proceso del parto que de cambios del metabolismo fosfocálcico.

Summary

Introduction

During delivery two situations are produced which can affect phosphocalcic metabolism, uterine contractions and placentary detachment. Both acts cause alterations, which can modify levels of bone remodelling markers.

Patients and methods

During delivery 38 women with normal pregnancies had their levels of calcium, phosphorous, albumin and parathormone (PTH) measured, also total alkaline phosphatase, serum osteocalcine, and pyridolines and their ratio with urinary creatinine.

Results

Total calcium levels were significantly inferior to those observed during pregnancy (p < 001), whilst albumin, alkaline phosphatase, PTH, and os-teocalcine did not have significant differences. The urinary pyridolines, exceptionally, had elevated values although these normalized if they were analysed in relation to creatinine.

Discussion

The modifications of bone remodelling markers during delivery are produced more by the process of delivery than by changes in phosphocalcium metabolism.

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Bibliografía

[1.]

NA Cross, LS Hillman, SH Allen, GF Krause, EN. Vieira.

Calcium homeostasis and bone metabolism during pregnancy, lactation and postweaning: a longitudinal study.

Am J Clin Nutr, 61 (1995), pp. 514-523

Medline

[2.]

K Seki, N Makimura, C Mitsui, J Hirata, I. Nagata.

Calcium regulating hormones and osteocalcin levels during pregnancy: A longitudinal study.

Am J Obstet Gynecol, 164 (1991), pp. 1248-1252

Medline

[3.]

D Mango, FG Tibollo, R Masciangelo, CV. Albanese.

Changes in bone markers of bone turnover and 25-hydroxyvitamin D pregnancy induced.

J Bone Miner Res, 9 (1994), pp. S196

[4.]

SJ Gallacher, WD Fraser, OJ Owens, FJ Dryburgh, FC Logue, A Jenkins, et al.

Changes in calciotrophic hormones and biochemical markers of bone turnover in normal human pregnancy.

Eur J Endocrinol, 131 (1994), pp. 369-374

Medline

[5.]

Salas A De Toro, Díez JL Dueñas, Revuelta E De Jaime, Salas R. De Toro.

Niveles de PTH intacta y de los marcadores bioquímicos de remodelamiento óseo durante la gestación: estudio longitudinal.

Prog Obstet Ginecol, 43 (2000), pp. 396-402

[6.]

RD Reitz, TA Daane, JR Woods, RL. Weinstein.

Calcium, magnesium, phosphorus and parathyroid hormone interrelationships in pregnancy and newborn infants.

Obstet Gynaecol, 50 (1977), pp. 701-705

[7.]

Salas A de Toro, Díez JL Dueñas, Millán JM López, Revuelta E. De Jaime.

Niveles de calcio total durante la gestación, el parto y el puerperio normales: estudio longitudinal.

Prog Obstet Ginecol, 41 (1999), pp. 703-708

[8.]

G Siddharth, LK Kamath, AF Kelley, F Smith, CH. Smith.

Transport and binding in calcium uptake by microvillous membrane of human placenta.

Am J Physiol, 262 (1992), pp. C789-C794

Medline

[9.]

lc J Stu, B Stulcová, M Smid, I. Sach.

Paralell mecanisms of Ca++transfer across the perfused human placental cotyledon.

Am J Obstet Gynecol, 170 (1994), pp. 162-167

Medline

[10.]

RM. Pitkin.

Calcium metabolism in pregnancy and the perinatal period: a review.

Am J Obstet Gynecol, 151 (1985), pp. 99-109

Medline

[11.]

LS Hillman, S Sateesha, M Haussler, W Wiest, E Slatopolsky, JG. Haddad.

Control of mineral homeostasis during lactation: Interrelationships of 25-hydroxyvitamin D, 24-25-dihydroxyvitamin D, 1,25-dihydroxyvitamin D, parathyroid hormone, calcitonin, prolactin, and estradiol.

Am J Obstet Gynecol, 139 (1981), pp. 471-476

Medline

[12.]

M Manabe, Y Saito, M Sagara, N Echizenya, T Tandoh, A. Kagiya.

Changes in bone mineral content and bone metabolism during pregnancy and puerperium.

Nippon Sanka Fujinka Gakkai Zasshi, 48 (1996), pp. 339-404

[13.]

A Saxe, J Levy, MR Pandian, G Gibson, S. Dean.

Parathyroid hormone and parathyroid hormone-related peptide in venous umbilical cord blood of healthy neonates.

J Perinat Med, 25 (1997), pp. 288-291

Medline

[14.]

Y Hirota, I Miyakawa, T. Anai.

Parathyroid hormone-related protein levels in maternal and cord blood.

Am J Obstet Gynecol, 177 (1997), pp. 702-706

Medline

[15.]

R Santamaría, F García, L Cabero, I. Mújica.

Modificaciones de diversos parámetros de función renal durante el parto.

Prog Obstet Ginecol, 36 (1993), pp. 118-127

[16.]

M. Swiet.

The cardiovascular system.

Clinical physiology in obstetrics, pp. 543-548

[17.]

MD Lindheimer, AI. Katz.

Renal physiology in pregnancy.

The kidney physiology and pathology, pp. 2017-2041

[18.]

SG Kamath, LK Kelley, AF Friedman, CH. Smith.

Transport and binding in calcium uptake by microvillous membrane of human placenta.

Am J Physiol, 262 (1992), pp. C789-C794

Medline

[19.]

GJ Fisher, LK Kelley, CH. Smith.

ATP-dependent calcium transport across basal plasma membranes of human placental trophoblast.

Am J Physiol, 252 (1987), pp. C38-C46

Medline

[20.]

R Smolarczyk, J Teliga, K Czajkowski, P Piekarski, E Romejko, J. Calcium-phosphous-magnesium homeostasis in women with threatened preterm delivery. Wojcicka-Jagodzinska.

Int J Gynaecol Obstet, 57 (1997), pp. 43-48

Medline

[21.]

F Bagnoli, S Sardelli, L. Vispi.

Calcitonina sérica del neonato a termine.

Boll Soc Ital Biol Sper, 58 (1982), pp. 556-561

Medline

[22.]

RL Horts, JH Thornton, NA. Jorgensen.

Calcium redistribution into subcutaneous fat at parturition in the dairy cows.

J Dairy Sci, 59 (1976), pp. 88-90

http://dx.doi.org/10.3168/jds.S0022-0302(76)84160-4 | Medline