New Zealand albino rabbits exhibited calcified aortic plaques and maximum average serum cholesterol levels of 1200 mg percent after twenty-three weeks on an atherogenic diet (250 to 500 mg percent cholesterol in ten percent corn oil; 200,00 I.U. vitamin D3 per month). One month following termination of the atherogenic diet, rabbits were treated with disodium edetate (Na2EDTA, 50 mg/kg body weight) via the marginal ear vein, on alternating days for a total of twenty infusions each. Aortae were examined for tissue calcium both quantitatively (direct microcomplexometric analysis) and histologically six weeks after completion of EDTA chelation therapy.

Barley plants grown in Mg, Mn, Zn and Cu deficient media were analyzed for specific activity, total activity and amount of RuDPCase present. Percent dry weight, as well as chlorophyll and soluble protein content were determined. All deficiencies caused lower chlorophyll and RuDPCase concentrations than occurred in the control. Soluble protein content, however, was higher in all deficient plants than in the control, either on a dry or a fresh weight basis. The addition of 18 μM Mn^2+ increased the activity of Mg^2+ containing RuDPCase preparations as much as 133% above normal. The specific activity of RuDPCase from Mg, Mn, Zn and Cu deficient plants was 60%, 118%, 159% and 149%, respectively, of the control. After 20 hours preincubation with Mg^2+, RuDPCase from Mg deficient plants attained 96% of the specific activity exhibited by the control. Total activity of RuDPCase from Mg, Mn, Zn and Cu deficient plants was 22%, 51%, 102% and 12 1%, respectively, of the control. Possible roles of Mn^2+ and Cu^2+ in the activation of RuDPCase are discussed.

Dissertation (PhD)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: The Effect of Statins on Bone and Mineral Metabolism Both statins and amino-bisphosphonates reduce the prenylation of proteins which are involved in cytoskeletal organization and activation of polarized and motile cells. Consequently statins have been postulated to affect bone metabolism. We investigated the effects of different doses of simvastatin (1,5,10 and 20mg/Kg/day), administered orally over 12 weeks to intact female Sprague-Dawley rats, and the effect of simvastatin 20mg/Kg/day in sham and ovariectomised rats, on femoral bone mineral density (BMD) and quantitative bone histomorphometry (QBH), compared to controls. Similarly, the affect of atorvastatin (2,5mg/Kg/day) and pravastatin (10mg/Kg/day) on BMD was investigated and compared to controls. BMD was decreased by simvastatin 1mg/Kg/day (p = 0.042), atorvastatin (p = 0,0002) and pravastatin (p = 0.002). The effect on QBH parameters differed with different doses of simvastatin (ANOVA; p = 0.00012). QBH parameters of both bone formation and resorption were equivalently and markedly increased by simvastatin 20mg/Kg/day in two independent groups of intact rats, and reflected by a relatively unchanged BMD. At lower doses, simvastatin 1mg/Kg/day decreased bone formation while increasing bone resorption as reflected by a marked decrease in BMD. Ovariectomised animals receiving simvastatin 20mg/Kg/day showed no change in BMD relative to the untreated ovariectomised controls, their increase in bone formation was smaller than in sham-operated rats receiving simvastatin and there was no change in bone resorption. The dose response curves of simvastatin for bone formation and resorption differed from each other. From these studies it is concluded that:- a) low-dose simvastatin (1mg/Kg/day), atorvastatin 2.5mg/Kg/day) and pravastatin 10mg/Kg/day) decrease BMD in rodents;b) 1mg/Kg/day simvastatin decreases bone formation and increases bone resorption and is reflected by a reduced BMD; c) 20mg/Kg/day simvastatin increases bone formation and resorption and results in an unchanged BMD; d) the effects of simvastatin on QBH differ at different dosages; e) the dose-response curves for QBH parameters of bone resorption and bone formation differ from each other; f) the effects of simvastatin seen in intact rats are not observed in ovariectomised rats; g) simvastatin is unable to prevent the bone loss caused by ovariectomy. / AFRIKAANSE OPSOMMING: Die Effek van Statiene op Been en Mineraal Metabolisme Beide statiene en aminobisfosfonate verminder die prenelasie van proteïene wat betrokke is in die sitoskeletale organisasie en aktivering van gepolariseerde en beweeglike selle. Gevolglik is dit gepostuleer dat statiene ‘n invloed sal hê op been metabolisme. Ons het die effekte van verskillende dossisse van simvastatien (1, 5, 10 en 20mg/Kg/dag), mondelings toegedien oor 12 weke aan intakte vroulike Sprague-Dawley rotte, en die effek van simvastatien 20mg/Kg/dag op skyn- en ge-ovariektomeerde rotte, op femorale been mineral digtheid (BMD) en kwantitatiewe been histomorfometrie (KBH), vergeleke met kontroles, ondersoek. Op ‘n soortgelyke manier is die effek van atorvastatien (2,5mg/Kg/day) en pravastatien (10mgKg/dag) op BMD ondersoek en vergelyk met kontroles. BMD is verminder deur simvastatien 1mg/Kg/dag (p = 0.042), atorvastatien (p = 0.0002) en pravastatien (p = 0.002). Die effekte op KBH parameters het verskil met verskillende dossisse van simvastatien (ANOVA; p = 0.00012). KBH parameters van beide been vormasie en resorpsie is vergelykend en merkbaar verhoog deur simvastatien 20mg/Kg/dag in twee onafhanklike groepe van intakte rotte en is vergesel deur ‘n relatiewe onveranderde BMD. Met laer dossisse het simvastatien 1mg/Kg/dag been vormasie verminder terwyl been resorpsie verhoog is en is weerspieël deur ‘n merkbaar verminderde BMD. Ge-ovariektomeerde diere wat simvastatien 20mg/Kg/dag ontvang het, het geen verandering in BMD relatief tot die onbehandelde geovariektomeerde kontroles getoon nie, en die toename in been vormasie was kleiner as in die skyngeopereerde rotte wat simvastatien ontvang het en daar was geen verandering in been resorpsie nie. Die dosis-respons kurwes vir simvastatien vir been vormasie en resorpsie het van mekaar verskil. Uit hierdie studies word die volgende gevolgtrekkings gea) lae-dosis simvastatien (1mg/Kg/dag), atorvastatien 2.5mg/Kg/dag en pravastatien 10mg/Kg/dag verminder BMD in knaagdiere; b) 1mg/Kg/dag simvastatien verminder been vormasie en verhoog been resorpsie en veroorsaak gevolglik ‘n velaging in die BMD; c) 20mg/Kg/dag simvastatien verhoog been vormasie en resorpsie met ‘n gevolglike onveranderde BMD; d) die effekte van simvastatien op KBH verskil met verskillende dossisse; e) die dosis-repons kurwes van been resorpsie en been vormasie veskil van mekaar f) die effekte van simvastatien wat waargeneem in intakte rotte word nie gesien in ge-ovariektomeerde rotte nie; g) simvastatien kannie die verlies van been wat veroorsaak word deur ovariektomie voorkom nie.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1935. / Typescript. With this are bound: The effect of feeding high amounts of soluble iron and aluminum salts / H.J. Deobald and C.A. Elvehjem. Reprinted from American journal of physiology, vol. 111, no. 1 (Feb. 1935), p. 118-123 -- Availability of calcium salts for chicks / by H.J. Deobald, C.A. Elvehjem, E.B. Hart, and J.G. Halpin. Reprinted from Poultry science, vol. XV, no. 1 (Jan. 1936), p. 42-47. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Este trabalho foi realizado com a finalidade de avaliar atividade da redutase do nitrato (RN), sintetase da glutamina (GS) e conteúdo de proteína total solúvel (PTS) em folhas de cafeeiro durante o desenvolvimento dos frutos em condições de campo. O experimento foi instalado em blocos ao acaso em esquema fatorial 3x6, constituído pela combinação de 3 doses de N (0, 150 e 350 kg ha-1) e avaliado em seis diferentes fases fenológicas (janeiro, fevereiro, março, abril, maio e junho), com sete repetições. No experimento foi utilizada a cultivar Catuaí Vermelho IAC 44 com seis anos implantada num Nitossolo Vermelho Eutroférrico, no município de Piracicaba-SP. Com relação à atividade da RN, GS e PTS em função das doses de N verificou incremento nos valores da atividade destas enzimas e do teor de proteína total solúvel em função da dose de N. As maiores atividades da RN foram obtidas no mês de janeiro (0,834, 1,370 e 1,781 µmol NO2 - g-1 MF h-1), bem como para a GS (82,47, 95,31 e 136,72 µmol γGH h-1 mg-1 PTS). O teor de proteína solúvel total (PTS) apresentou a mesma tendência (0,62, 5,66 e 6,52 mg mL-1). Estes valores foram obtidos em frutos na fase chumbinho. Durante o desenvolvimento dos frutos do cafeeiro a atividade das enzimas estudadas e o conteúdo de PTS foliar diminuíram, ao longo do tempo de janeiro a junho (maturação frutos). / The aim of this work was to evaluate the nitrate reductase (NR) and glutamine synthetase (GS) activity, total soluble protein content (PTS) in coffee leaves during the fruits development in field conditions. The study was carried out in ESALQ/USP (University of São Paulo), Piracicaba, São Paulo, Brazil in a Red Nitosol eutrofic. The experimental design was a complete randomized, in a factorial outline 3 x 6, constituted by combination of 3 levels (0, 150 and 350 kg ha-1) of nitrogen in six different periods (January, February, March, April, May and June) in plants (Cultivar Catuaí Vermelho IAC 44). The RN, GS activity and leaves PTS content was linear increased in relation of levels of N applied. In accordance with the present study, the enzymes had presented greater activity during the January than other months (0,834, 1,370 and 1,781 µmol NO2 - g-1 DF h-1) of RN; (82,47, 95,31 and 136,72 µmol γGH h-1 mg-1 PTS) of GS and (0,62, 5,66 and 6,52 mg mL-1) of total soluble protein (PTS), in the treatments T0, T1 and T2, respectively. In January, the fruits were young grains and this period the coffee plant has high enzymatic activity. However, the capacity of nitrate assimilation during the annual cycle of coffee plants can be change through the environment and climatic variations and this phase (January) was verified a great precipitation. During the coffee fruits development, the RN and GS activity and the foliar PTS content had decreased, this occur due to the process of senescence of leaves, promote it the remobilization to other plant organs, as seed filling.

Este trabalho foi realizado com a finalidade de avaliar atividade da redutase do nitrato (RN), sintetase da glutamina (GS) e conteúdo de proteína total solúvel (PTS) em folhas de cafeeiro durante o desenvolvimento dos frutos em condições de campo. O experimento foi instalado em blocos ao acaso em esquema fatorial 3x6, constituído pela combinação de 3 doses de N (0, 150 e 350 kg ha-1) e avaliado em seis diferentes fases fenológicas (janeiro, fevereiro, março, abril, maio e junho), com sete repetições. No experimento foi utilizada a cultivar Catuaí Vermelho IAC 44 com seis anos implantada num Nitossolo Vermelho Eutroférrico, no município de Piracicaba-SP. Com relação à atividade da RN, GS e PTS em função das doses de N verificou incremento nos valores da atividade destas enzimas e do teor de proteína total solúvel em função da dose de N. As maiores atividades da RN foram obtidas no mês de janeiro (0,834, 1,370 e 1,781 µmol NO2 - g-1 MF h-1), bem como para a GS (82,47, 95,31 e 136,72 µmol γGH h-1 mg-1 PTS). O teor de proteína solúvel total (PTS) apresentou a mesma tendência (0,62, 5,66 e 6,52 mg mL-1). Estes valores foram obtidos em frutos na fase chumbinho. Durante o desenvolvimento dos frutos do cafeeiro a atividade das enzimas estudadas e o conteúdo de PTS foliar diminuíram, ao longo do tempo de janeiro a junho (maturação frutos). / The aim of this work was to evaluate the nitrate reductase (NR) and glutamine synthetase (GS) activity, total soluble protein content (PTS) in coffee leaves during the fruits development in field conditions. The study was carried out in ESALQ/USP (University of São Paulo), Piracicaba, São Paulo, Brazil in a Red Nitosol eutrofic. The experimental design was a complete randomized, in a factorial outline 3 x 6, constituted by combination of 3 levels (0, 150 and 350 kg ha-1) of nitrogen in six different periods (January, February, March, April, May and June) in plants (Cultivar Catuaí Vermelho IAC 44). The RN, GS activity and leaves PTS content was linear increased in relation of levels of N applied. In accordance with the present study, the enzymes had presented greater activity during the January than other months (0,834, 1,370 and 1,781 µmol NO2 - g-1 DF h-1) of RN; (82,47, 95,31 and 136,72 µmol γGH h-1 mg-1 PTS) of GS and (0,62, 5,66 and 6,52 mg mL-1) of total soluble protein (PTS), in the treatments T0, T1 and T2, respectively. In January, the fruits were young grains and this period the coffee plant has high enzymatic activity. However, the capacity of nitrate assimilation during the annual cycle of coffee plants can be change through the environment and climatic variations and this phase (January) was verified a great precipitation. During the coffee fruits development, the RN and GS activity and the foliar PTS content had decreased, this occur due to the process of senescence of leaves, promote it the remobilization to other plant organs, as seed filling.

Thesis (MScMedSc) -- Stellenbosch University, 2001. / ENGLISH ABSTRACT: Osteopenia is a well documented complication of anorexia nervosa (AN). The pathogenesis of this bone loss is presently poorly defined in the literature. Pathogenetic mechanisms that have been implicated include certain nutritional factors, exercise abuse, hypogonadism, hypercortisolism and/or vitamin 0 deficiency. We studied, 59 Caucasian eating disorder patients aged 15-45yr. The eating disorder was classified by a single, qualified psychiatrist according to OSM IV R criteria as either anorexia nervosa (AN: n =25), bulimia nervosa (BN: n = 17) or eating disorder not otherwise specified (EONOS: n = 17). All patients were subjected to a detailed dietary and general history. We assessed the prevalence and severity (OEXA), the nature (osteocalcin, deoxypyridinoline) and site (vertebral versus hip) of osteopenla in these patients. he role of nutritional factors (energy intake, weight, height, BMI, plasma albumin, lipids), physical activity, hypercortisolemia (plasma and urinary free cortisol), vitamin 0 deficiency (plasma 250HD) and hypogonadism (amenorrhoea, E2, LH, FSH) in the pathogenesis of bone loss were also evaluated. Mild osteopenia (BMO decreased by more than 1SO below age-matched controls) was documented in 46% of the total study population, with more marked osteopenia (Z-Score < -2 SO) present in 15%. Both vertebral and hip osteopenia were documented. In the study population those patients with AN (Lumbar BMO (q/cm") = 0.869 ± 0.121) were most likely to develop osteoporosis, although a significant percentage of patients with BN (Lumbar BMO (q/crn") = 0.975 ± 0.16) and EONOS (Lumbar BMO (g/cm2) = 0.936 ± 0.10) were also osteopenic (29% and 35% respectively). Twenty four percent (24%) of the total patient population had a history of fragility fractures. These fractures were reported more commonly amongst patients with AN and EONOS (28% and29.4%). Fracture prevalence was however similar in patients with normal and low bone mass. Conventional risk factors were similar in patients with normal and low bone mass, except for a significantly longer duration of amenorrhoea (p = 0.009), a lower BMI (p = 0.0001) and greater alcohol consumption (p = 0.05) in the osteopenic patients. Nutritional parameters (S-albumin, protein, Ca, and P04 intakes), physical activity, as well as 25(OH) vitamin D levels were similar in AN and BN subjects, as well as in patients with a low versus normal BMD. Plasma and urine cortisol levels were also similar in these subgroups. With the exception of two patients with borderline osteopenia, significant bone loss was only documented in those patients with a past or current history of amenorrhoea. In the total patient population the duration of amenorrhoea was significantly (p<0.009) longer in patients with osteopenia versus those with a normal bone mass. A significant negative correlation between BMD (Z-Score) and duration of amenorrhoea was also documented in the total patient population (r = -0.4, P = 0.001) as well as in all three eating disorder groups (AN r - -0.4, P = 0.03; BN r = - 0.6, P = 0.008; EDNOS r = -0.6, P = 0.005). In the total patient population, those patients with amenorrhoea, had lower BMD and BMI values and lower estrogen levels compared to those with a normal menstrual cycle. We conclude that osteopenia commonly attends AN, as well as BN and EDNOS. Nutritional (with the exception of alcohol consumption) and mechanical factors as well as hypercortisolemia did not appear to contribute significantly to bone loss in this study population. Hypogonadism appeared to be the main cause of the bone loss observed in these patients. / AFRIKAANSE OPSOMMING: Osteopenie is In welbekende komplikasie van anorexia nervosa (AN). Die patogenese van hierdie beenverlies is swak in die huidige literatuur omskryf en nutrisiele faktore, 'n vita mien 0 gebrek, oormatige oefening, hiperkortisolemie en hipogonadisme word onder andere qeimpliseer. Vir die doel van die studie is In totaal van 59 Kaukasier eetsteurnis pasiente patients volledig ondersoek. Die tipe eetsteurnis is deur In enkel gekwalifiseerde psigiater volgens die DSM IV R kriteria geklassifiseer as anorexia nervosa (AN: n =25) of bulimia nervosa (BN: n = 17) of eetsteurnis nie anders gespesifiseer (EDNOS: n = 17). Elke pasient is ook aan In gedetailleerde dieet en algemene risikofaktor vraelys vir osteoporose onderwerp. Die voorkoms en graad (DEXA), die aard (osteokalsien, deoksipiridinolien) asook die tipe (werwelkolom/heup) osteopenie is ondersoek. Die rol van nutrisiele faktore (totale kalorie-inmame, gewig ,Iente LMI, plasma albumien, lipiede) en vitamien 0 gebrek, oefening, hiperkortisolemie (plasma en urinere kortisol) en hipogonadisme (amenoree, plasma E2, LH,FSH) in die patogenese van die beenverlies is ook evalueer. Matige osteopenie (BMD meer as 1 SO onder die van ouderdomskontrole) is in 46% van die totale pasientpopulasie gedokumenteer, met erge osteopenie (Z-Telling < -2) in 15%. Aantasting van beide werwelkolom en heup is aangetoon. In hierdie studiepopulasie kom osteopenie meer algemeen voor in die AN (Lumbaal BMD (g/cm2) = 0.869 ± 0.121) groep (64%) in vergelyking met BN (Lumbaal BMD (g/cm2) = 0.975 ± 0.16) (29%) en (EDNOS) (Lumbaal BMD (g/cm2) = 0.936 ± 0.10) (32%). Vier-en-twintig persent van die totale pasientpopulasie het In geskiedenis van frakture gehad. Frakture het meer algemeen in AN en EDNOS pasiente voorgekom (28% en 29%). Pasiente met 'n lae beenmassa was gekenmerk deur In betekenisvolle laer LMI (p = 0.0001), hoer alkolholverbruik (p = 0.05) en langer duurte van amenoree(p = 0.009). Nutrisiele parameters (s-albumien, protetene, Ca, P04 inname) oefening, asook 25(OH) vitamien 0 vlakke was soortgelyk in AN en BN pasiente. Hierdie parameters het ook nie verskil tussen pasiente met osteopenie en die met In normale BMD nie. Plasma en urinere vry kortisolvlakke was ook soortgelyk in hierdie twee groepe. Betekenisvolle beenverlies (met die uitsondering van twee pasiente met grenslyn osteopenie) het slegs voorgekom in pasiete met 'n huidige of In vorige geskiedenis van amenoree. In die totale pasientpopulasie was die duurte van amenoree (p< 0.009) betekenisvollanger in die pasiente met osteopenie. In Betekenisvolle negatiewe korrelasie tussen BMD (Z-Telling) en die duurte van amenoree in die toale pasient populasie (r = -0.4; P = 0.001) asook in al drie eetsteurnis groepe (AN: r = -0.4; P = 0.03; BN: r = -0.06; P = 0.008; EDNOS: r = - 0.6, P = 0.005) is aangetoon. In die groep as 'n geheel, het die amenoree pasiente In laer LMI, E2vlakke en BMD gehad in vergelyking met die pasiente met normale menses. Opsommend dus, kom osteopenie algemeen in pasiente met AN, asook BN en EDNOS voor. In Betekenisvolle bydrae van nutrisiele (met die uitsondering van alkoholinname) en meganiese faktore asook hiperkortisolemie tot been verlies, kon nie in hierdie tudie populasie gedemonstreer word nie. Hipogonadisme is as die hoofoorsaak van osteopenie in die pasiente qefdentifiseer.

INTRODUÇÃO: Os níveis séricos de fósforo (P) têm sido associados a doenças cardiovasculares e mortalidade em pacientes com doença renal crônica e na população geral. Estudos in vitro demonstram que altas concentrações de fósforo extracellular são capazes de induzir calcificação vascular e disfunção endotelial. O Fibroblast Growth Factor 23 (FGF-23) é um hormônio fosfatúrico e foi relacionado à presença de aterosclerose em pacientes idosos. OBJETIVO: O objetivo deste estudo foi investigar as relações entre P, FGF-23 e outros atores do metabolismo mineral e a ocorrência de doença arterial coronariana em pacientes com função renal preservada. MÉTODOS: Duzentos e noventa pacientes clinicamente estáveis com indicação de cineangiocoronariografia eletiva e clearance de creatinina superior a 60 ml/min/1.73 m2 foram submetidos à Tomografia Computadorizada Multislice para avaliação da calcificação coronariana e coleta de sangue para dosagens bioquímicas. A calcificação coronariana foi quantificada através do Escore de Agatston (EA) e os Escores de Friesinger e Gensini foram calculados para quantificar a obstrução coronariana. RESULTADOS: A média de idade dos pacientes foi 58,1± 9,3 anos, 81% eram hipertensos e 35,5% diabéticos. Os pacientes foram divididos em grupos de acordo com o EA utilizando-se como ponto de corte o valor de 10 Unidades Hounsfield (HU). O P sérico foi maior no grupo de pacientes com EA > 10 HU (3,63 0,55 vs 3,49 0,52mg/dL; p=0,019). Cada 1 mg/dL de elevação no P sérico associou-se a um aumento de 92% no risco de apresentar o EA > 10HU [Odds Ratio (OR) =1,92, CI 1,56-3,19; p=0,01]. Quando os pacientes foram divididos de acordo com a mediana do Escore de Friesinger (4 pontos), o grupo com valores superiores à mediana apresentou P sérico maior (3,6 0,5 vs. 3,5 0,6 mg/dl; p=0,04) e FGF-23 menor (mediana 40,3 pg/mL intervalo interquartil 24,1-62,2 vs. 45,7 pg/mL intervalo interquartil 31,7-76,1; p=0,01) quando comparado àquele com valores menores ou iguais a 4. Pacientes no tercil mais alto do escore de Gensini também apresentaram P sérico mais elevado que os demais (p<0,05). Nas análises de regressão logística uni e multivariadas, cada 1 mg/dL de elevação no P sérico implicou em um aumento de 74% no risco de apresentar o Escore de Friesinger superior à mediana (OR 1,74, CI 1,06- 2,88; p=0,03) e o FGF-23 sérico foi preditor negativo do Escore de Friesinger (OR 0,26, CI 0,11-0,63; p=0,002) Os níveis séricos de cálcio e paratormônio não mostraram associação com a presença de doença coronariana. CONCLUSÃO: Em pacientes com suspeita de doença arterial coronariana e função renal preservada, o fósforo sérico foi preditor da presença de calcificação e obstrução coronariana e houve uma associação negativa entre o FGF-23 sérico e a presença de obstrução coronariana. / INTRODUCTION: Serum phosphorus (P) has been associated with cardiovascular diseases and mortality in chronic kidney disease patients and in the general population. In vitro studies suggest that excessive phosphorus induces vascular calcification and endothelial dysfunction. Fibroblast growth factor 23 (FGF-23) is a phosphaturic hormone and has been correlated to atherosclerosis in the community. AIM: This study intended to investigate the associations between P, FGF-23 and other mineral metabolism players and coronary artery disease in patients with preserved renal function. METHODS: Two-hundred ninety patients with a creatinine clearance higher than 60ml/min/1,73m2 undergoing elective coronary angiography were submitted to Multislice Computed Tomography in order to evaluate coronary calcification and blood was collected for biochemical analyses. Coronary artery calcification was quantified using the Agatston Score (AS). Friesinger (FS) and Gensini Scores (GS) were calcutalet to quantify coronary obstruction. RESULTS: Considering the whole population, mean age was 58.1±9.3 anos, 81% were hypertensive and 35.5% were diabetics. Patients were divided according to AS using the value of 10 Hounsfield Units (HU) as the cutoff.point. Serum phosphorus was higher in patients with an AS > 10HU when compared to the group with an AS 10 HU (3.63 0.55 vs 3.49 0.52mg/dL, p=0.019). Each 1 mg/dL of elevation in the serum phosphorus implied a 92% additional risk of presenting an AS > 10 HU [Odds Ratio (OR) =1.92, CI 1.56-3.19; p=0.01]. Patients were also divided using the median Friesinger score (4 points) as the cutoff value. Serum phosphorus was higher (3.6 0.5 vs. 3.5 0.6 mg/dl, p=0.04) and intact FGF-23 was lower (median 40.3 interquartile range 24.1-62.2 pg/mL vs. 45.7 interquartile range 31.7- 76.1 pg/mL, p=0.01) in the FS > 4 group. Patientis in the higher Gensini Score tertile presented elevated serum phosphorus when compared to the other groups (p<0,05). In the uni and multivariate logistic regression analyses, a rise of 1 mg/dL of serum phosphorus carried a 74% increase in the risk of having a FS higher than 4 (OR 1.74, CI 1.06-2.88; p=0.03) and FGF-23 was a negative predictor of FS (OR 0.26, CI 0.11-0.63; p=0.002). Serum calcium and parathormone were not associated with the presence of coronary artery disease. CONCLUSIONS: In patients with suspected coronary artery disease and preserved renal function, phosphorus was predictive of both coronary artery calcification and obstruction. There was a negative association between FGF-23 and coronary obstruction

INTRODUÇÃO: Os distúrbios minerais e ósseos (DMO) da doença renal crônica (DRC) estão associados ao aumento do risco de fratura, estudos relatam cerca de 3% de fraturas neste grupo de pacientes, e as mesmas ocorrem mais precocemente quando comparadas à população geral, ou seja, 16 e 13 anos antes para homens e mulheres, respectivamente. A melhora no tratamento do DMO ainda não impactou na diminuição das fraturas, assim a melhor compreensão da fisiopatologia das mesmas provavelmente contribuiria para novas abordagens terapêuticas. OBJETIVOS: avaliar informes de fraturas, de ossos longos, de um banco de biopsias ósseas de pacientes com DRC em hemodiálise, e comparar, as características clínicas, bioquímicas e os resultados da análise histomorfométrica do osso trabecular e cortical desses pacientes com o de outros sem fraturas, pareados para idade, sexo e tempo de hemodiálise. Avaliamos também, por imunohistoquimica, a expressão de proteínas envolvidas na formação (SOST) e na mineralização óssea (DMP1, MEPE) de ambos os grupos. MÉTODOS: dezessete pacientes com fratura e igual número de controles foram estudados. RESULTADOS: A prevalência de fraturas foi de 5,5 fraturas/1000 pacientes ano a maioria deles tinha menos de 60 anos e tempo em hemodiálise inferior a 10 anos. Quanto a analise dos dados bioquímicos somente os níveis de fósforo sérico foram significativamente mais baixos nos pacientes com fratura comparada aos controles. Os resultados da análise histomorfométrica revelaram que a totalidade dos pacientes com e sem fratura apresentava doença de alta remodelação e nos fraturados detectamos menor volume e espessura trabecular, maior superfície osteóide, menor superfície de reabsorção além de menor superfície mineralizante, taxa de formação e maior tempo de intervalo para mineralização óssea quando comparados aos controles. Não encontramos diferenças na análise da espessura e porosidade cortical entre os dois grupos e a expressão da DMP1 no osso cortical foi menor e da SOST no osso trabecular foi maior nos pacientes fraturados comparados aos controles além de se associarem com parâmetros estruturais, de formação, de reabsorção e de mineralização. CONCLUSÕES: No banco de informes de biópsias ósseas analisado, encontramos alta prevalência de pacientes com fratura. Os pacientes com e sem fratura apresentavam doença de alta remodelação, porém os fraturados apresentavam maior comprometimento da microarquitetura óssea assim como menor formação e maior defeito de mineralização quando comparados aos pacientes sem fratura. A expressão de proteínas ósseas envolvidas na formação e mineralização óssea se correlacionaram com parâmetros envolvidos na remodelação óssea / INTRODUCTION: Mineral and bone disorders (BMD) of chronic kidney disease (CKD) are associated with increased risk of fracture. Studies report about 3% of fractures in this group of patients, and these occur earlier than in the general population, namely 16 and 13 years earlier for men and women, respectively. Improvement in BMD treatment has not yet impacted reduction of fractures, therefore a better understanding of the pathophysiology of fractures would probably contribute to new therapeutic approaches. OBJECTIVES: evaluate report of long bone fractures from a bank of bone biopsies from patients with CKD on hemodialysis, and compare clinical and biochemical characteristics as well as the results of the histomorphometric analysis of trabecular and cortical bone of these patients with that of others without fractures, paired for age, gender, and time on hemodialysis. We also evaluated the expression of proteins involved in formation (SOST) and bone mineralization (DMP1, MEPE) of both groups by immunohistochemistry. METHODS: seventeen patients with fracture and an equal number of controls were studied. RESULTS: The prevalence of fractures was 6%, the majority of the patients were less than 60 years old, and the time on hemodialysis was less than 10 years. Regarding the analysis of the biochemical data, only serum phosphorus levels were significantly lower in patients with fracture compared to controls. Results of the histomorphometric analysis revealed that all the patients with and without fracture had high turnover disease, and in the fractured ones we detected a smaller trabecular volume and thickness, greater osteoid surface, and smaller surface of resorption in addition to smaller mineralizing surface, formation rate and longer time interval for bone mineralization when compared to controls. We did not find differences in the analysis of thickness and cortical porosity between the two groups; the DMP1 expression in the cortical bone was smaller and the SOST in the trabecular bone was higher in the fractured patients compared to that of controls, besides being associated with structural parameters, formation, reabsorption and mineralization. CONCLUSIONS: In the database of analyzed bone biopsies, we found low prevalence of patients with fracture. Patients with and without fracture had high turnover disease, but the fractured ones presented more impaired bone microarchitecture as well as lower formation and greater mineralization defect when compared to the patients without fracture. The expression of bone proteins involved in bone formation and mineralization correlated with parameters involved in bone remodeling

A acidose metabólica causa perda de mineral ósseo e a estimulação mecânica causa remodelamento ósseo adaptativo. A reabsorção óssea que caracteriza essas mudanças ósseas depende da acidificação extracelular pela secreção vetorial de H+ pelos osteoclastos. A H+-ATPase vacuolar em paralelo com o trocador Cl-/H+ (CLC7) são os mecanismos conhecidos envolvidos na reabsorção óssea, entretanto, os osteoclastos também expressam canais para H+ dependentes a voltagem. Este trabalho foi realizado para avaliar a contribuição dos canais para H+ na função celular visando à compreensão de seu relacionamento com a H+-ATPase vacuolar e o CLC7 (1); analisar se o fluxo de fluido extracelular modifica a secreção de H+ (2) e avaliar a diferenciação dos osteoclastos in vitro sob acidose metabólica devido à redução do HCO3- (3). Osteoclastos de ratos Wistar foram obtidos diretamente dos animais ou foram diferenciados in vitro (com M-CSF e RANKL) e semeados sobre vidro, plástico ou substratos mineralizados em <font face=\"Symbol\">&#945;-MEM + 10% SFB, em pH 7,4 ou 6,9, e então mantidos em incubadora com 5% CO2, a 37<font face=\"Symbol\">&#176;C. A diferenciação celular foi avaliada pela contagem de células TRAP-positivas ou de núcleos marcados por DAPI. A secreção de H+ foi avaliada por epifluorescência, utilizando-se BCECF-AM, sensível a pH. Os registros do pH intracelular foram feitos na vigência de soluções tamponadas por HEPES, na ausência de CO2/HCO3- (pH 7,4, 300 mOsm/L H2O, a 37<font face=\"Symbol\">&#176;C), na presença ou ausência de perfusão contínua de fluido extracelular a uma velocidade de 5 ml/min. Na ausência de perfusão, os osteoclastos exibiram variações cíclicas do pHi (acidificação e alcalinização espontâneas), com período de 12 a 45 minutos (n = 35) e amplitude de 0,12 a 1,43 unidades de pHi. As oscilações não foram abolidas por concanamicina (100 mM) (n = 3), por NPPB (100 <font face=\"Symbol\">mM) (n = 3), na ausência de Na+ extracelular (n = 5) ou na ausência de Cl- extracelular (n = 3). O fluxo de fluido aboliu as oscilações e a ausência de Cl- extracelular modificou significativamente seu padrão. Na ausência de perfusão, a secreção de H+ após acidificação intracelular induzida foi abolida por Zn2+ (100 <font face=\"Symbol\">mM) (n = 5). Além disso, na presença de perfusão, a secreção de H+ após acidificação intracelular induzida foi abolida por NPPB (n = 4) e não foi abolida por bafilomicina (200 nm) (n = 3). A acidose metabólica não modifica o número de osteoclastos diferenciados in vitro, entretanto, o tratamento das culturas com Zn2+ causou redução do numero de células mononucleares e aumento relativo do número de osteoclastos multinucleados em relação ao controle tanto em pH 7,4 quanto em pH 6,9. / Metabolic acidosis can cause a loss of bone mineral and the mechanic stimulation can cause adaptative bone remodeling. The bone resorption characteristic of these bone changes aforementioned depends on the extracellular acidification by osteoclastmediated proton secretion. The H+ secretion by vacuolar H+-ATPase together with Clsecretion through a Cl-/H+ exchanger (CLC7) are the known mechanisms involved in the bone resorption; however, osteoclasts also express voltage-gated proton channels. The proposed aims of these work were to evaluate the contribution of proton channels in the osteoclast function for better understanding its relation with vacuolar H+-ATPase and CLC7 (1); to analyze whether the flow of extracellular fluid modifies the H+ secretion or not (2); and to analyse the osteoclast differentiation in vitro under metabolic acidosis due to HCO3- reduction (3). Osteoclasts were freshly isolated or generated from bone marrow precursor cells (using M-CSF and RANK- L) from of Wistar rats. The cells were placed on glass coverslips, plastic coverslips, or on mineralized substrate in <font face=\"Symbol\">&#945;-MEM + 10% FBS, pH 7.4 or 6.9, and then maintained in a 5% CO2 incubator at 37<font face=\"Symbol\">&#176;C. The differentiation was analyzed by counting of TRAP-stained cells or DAPIstained nuclei. The H+ secretion was analysed by epifluorescence, using the pHsensitive dye BCECF-AM. The intracellular pH record was done using a standard HEPES-buffered solution free of CO2/HCO3- (pH 7.4, 300 mOsm/L H2O, at 37<font face=\"Symbol\">&#176;C), with or without continuous perfusion of extracellular fluid at a rate of 5 ml/min. In the absence of perfusion, the osteoclasts exhibit cyclic pHi variations (spontaneous acidification and alkalinization), with a period of 12 to 45 minutes (n = 35) and amplitude difference between maximal and minimal pHi of 0.12 to 1.43 units pHi. These oscillations were not abolished in the presence of oncanamycin (100 mM) (n = 3), NPPB (100 <font face=\"Symbol\">mM) (n = 3), in the absence of Na+ (n = 5) or in the absence of Cl- (n = 3) in the extracellular solution. The fluid flow itself abolished the pH oscillations and the absence of extracellular Cl- modifies significantly these patterns. In the absence of perfusion, the H+ secretion after induced intracellular acidification was abolished by Zn2+ (100 <font face=\"Symbol\">mM) (n = 5). In addition, in the presence of perfusion, the H+ secretion after induced intracellular acidification was abolished by NPPB (n = 4) and was not abolished by bafilomycin (200 nm) (n = 3). Metabolic acidosis does not modify the number of osteoclasts differentiated in vitro, however, when the cell culture was treated with Zn2+, there was a significant reduction in the number of mononuclear cells and a relative increase in the number of multinucleated osteoclasts compared to control, both in pH 7.4 and pH 6.9 medium.