Apheresis affects bone and mineral metabolism

作者：Amrein Karin^*; Katschnig Claudia; Sipurzynski Sabine; Stojakovic Tatjana; Lanzer Gerhard; Stach Elisabeth; Pieber Thomas R; Dobnig Harald

来源：Bone, 2010, 46(3): 789-795.

DOI：10.1016/j.bone.2009.11.008

• Acid-base balance
• Calcium
• Vitamin D
• Osteoporosis
• Blood donation
• Metabolic alkalosis
• Bone mineral density

Background: Apheresis is a procedure to selectively obtain blood components. For the collection process citrate is routinely used. It inhibits coagulation by binding to ionized calcium and leads to metabolic alkalosis.
Objective: Whether regular apheresis affects bone and mineral metabolism is unknown. The intention of this study was to investigate 1) the acute effects of apheresis on acid-base balance, bone and mineral metabolism and 2) to compare bone mineral density (BMD) at the lumbar spine and hip of donors to matched control subjects.
Design: In this open, observational, single-center, cross-sectional study we enrolled 102 regular plasma and thrombocyte donors to purse objective 1) and compared those to 102 matched controls (CTR) for objective 2). Results: Platelet donation led to significant decreases in serum ionized calcium (- 17%) and phosphate (- 18%). to marked increases in base excess (57%) and PTH levels (192%) during apheresis. Baseline biochemical comparisons between donors and CTR revealed significantly lower values for donors for serum calcium, albumin, and 25-hydroxyvitamin D levels. Mean Z-score at the lumbar spine adjusted for BMI, average physical activity and daily calcium intake was lower for donors (-0.28 +/- 0.11) when compared to CTR subjects (0.06 +/- 0.11, P<0.05). Total and neck femoral BMD was also lower in the donor group, however, this difference was not significant.
Conclusions: Exposure to citrate during the apheresis procedure acutely affects mineral and bone metabolism. Regular donations of blood components compromised BMD at the lumbar spine. If confirmed, strategies to prevent long-term effects on bone need to be formulated.

• 出版日期2010-3
• 单位河北医科大学