Hipovitaminosis D y marcadores bioquímicos del metabolismo óseo en niños con leucemia
DOI:
https://doi.org/10.5281/zenodo.14199833Palabras clave:
Deficiencia de Vitamina D, Leucemia-Linfoma Linfoblástico de Células Precursoras, Niño, Hormona Paratiroidea, FósforoResumen
Introducción: la 25 hidroxivitamina D (25(OH)D) desempeña un papel fundamental en el mantenimiento de la salud ósea. El tratamiento del paciente pediátrico con leucemia linfoblástica aguda (LLA), tiene un efecto negativo sobre el metabolismo óseo.
Objetivo: describir la frecuencia de hipovitaminosis D y los cambios en las concentraciones séricas de 25(OH)D, marcadores bioquímicos y hormonales del metabolismo óseo entre el diagnóstico y la remisión.
Material y métodos: estudio de cohorte, longitudinal, prospectivo, en pacientes pediátricos (4-17 años) con diagnóstico de LLA de novo de células B y sin tratamiento previo. Se tomó una muestra de sangre periférica para determinar las concentraciones de 25(OH)D, hormona paratiroidea (PTH), fósforo y calcio iónico.
Resultados: se incluyeron 40 pacientes, se presentaron 7 pérdidas durante el seguimiento, por lo que sólo se analizaron 33. El 91% de los niños presentaron hipovitaminosis D. Observamos un incremento de las concentraciones del calcio iónico con respecto a los niveles basales (1.1 mmol/L frente a 1.2 mmol/L, p = 0.002). El análisis de los Δ de las concentraciones séricas de PTH y 25(OH)D mostró una relación inversa (rho = -0.397, p = 0.024).
Conclusiones: estos hallazgos confirman una alta frecuencia de hipovitaminosis D. Niveles bajos de 25(OH)D pueden comprometer la absorción de calcio y generar un aumento compensatorio de PTH.
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