25-hydroxyvitamin-d-2 and Bone-Diseases--Metabolic

Estimation of the parathyroid hyperplasia prevalence after the ChNPP accident in adults exposed to ion izing radiation and their descendants using the diagnostic ultrasound and its methodology elaboration.. The pilot prospective study of the prevalence of parathyroid hyperplasia among the Chornobyl Nuclear Power Plant (ChNPP) accident adult survivors (n=686) and their descendants (54 children) was performed using diagnostic ultrasound examination of thyroid and parathyroids. Among the study subjects there were 339 ChNPP accident clean up workers (ACUW), 32 persons were evacuated from the 30 km exclusion zone and 224 ones were included to the control group. Diagnostic ultrasound of thyroid and parathyroids was performed according to the standard method. Additionally, in children with parathyroid hyperplasia an additional assay of 25 hydroxyvitamin D levels in serum was performed. In calculating the statistical significance, its level p < 0.05 was considered statistically significant.. Parathyroids are a few small but critically important endocrine glands that synthesize parathyroid hormone, regulating mainly phosphoric calcium metabolism. Insufficient (hypoparathyroidism) or excessive (hyperparathy roidism) function of parathyroids is harmful to the patients affecting the state of nervous and cardiovascular sys tem. Parathyroidss can accumulate isotopes of cesium, strontium and radioactive iodine. The available data testify to an increased incidence of clinically significant hyperplasia of parthyroids (more than 9 mm in adults and more than 5 mm in children) among persons exposed toionizng radiation as a result of the accident at the ChNPP (28.64%) and their descendants (23.8-70.6%). First of all are concerned those adults who live in contaminated areas in comparison with the control group (24.15% in not irradiated). Evacuees from the 30 km exclusion zone being the category of people who were exposed to the absorbed iodine isotopes in the first days of the Chernobyl accident are the another risk group. These data demonstrate sensitivity of parathyroidss to the impact of incorpo rated isotopes (iodine, cesium and strontium), which in the long term exposure create conditions for structural and functional changes in regulation of phosphorous calcium metabolism being the basis for a significant prevalence of osteopenia and osteoporosis in irradiated individuals and their descendants. A number of further studies are required to clarify the findings and to disclose the hormonal mechanisms of radiation effects on parathyroids.. Parathyroid glands are radiosensitive and susceptible to effects of strontium, cesium and iodine iso topes, which cause parathyroid irradiation and subsequent structural and functional changes, being a prerequisite for development of osteopenia and osteoporosis in the ChNPP accident survivors and their descendants. High inci dence of parathyroid hypertrophy is found in the inhabitants of the radiation contaminated territories (long term irradiation by cesium isotopes), as well as in evacuated from the 30 km exclusion zone (irradiation by iodine iso topes in the early days of the accident).. Meta. Vyznachennia poshyrenosti giperplaziy̆ pryshchytopodibnykh zaloz u oprominenykh vnaslidok avariï na ChAES do roslykh ta ïkh nashchadkiv pry skryningovomu ul'trazvukovomu doslidzheni ta vidpratsiuvaty y̆ogo metodologiiu. Materialy ta metody. Pilotne prospektyvne doslidzhennia poshyrenosti giperplaziï PShchPZ sered osib, postrazh dalykh vnaslidok avariï na Chornobyl's'kiy̆ atomniy̆ elektrostantsiï (ChAES) doroslogo viku (686 osib) ta ïkh na shchadkiv (54 ditey̆) provedeno UZD ShchPZ ta PShchPZ, z iakykh 339 vidnosylysia do uchasnykiv likvidatsiï naslidkiv avariï na ChAES, 32 osoby – evakuy̆ovani z 30 km zony vidchuzhennia ta 224 osib z grupy kontroliu. Provedeno ul'trazvu kove doslidzhennia shchytopodibnoï ta pryshchytopodibnykh zaloz za standartnoiu metodykoiu. Dodatkovo u ditey̆ z giperplaziieiu pryshchytopodibnykh zaloz provodylos' vybirkove doslidzhennia rivnia 25 gidroksyvitaminu D u syro vattsi krovi. Pry rozrakhunku statystychnoï znachushchosti, ïï riven' r < 0,05 vvazhaly statystychno dostovirnym. Rezul'taty. Pryshchytopodibni zalozy – tse dekil'ka nevelykykh ale vplyvovykh endokrynnykh zaloz, shcho syntezu iut' paratgormon, reguliuiut', golovnym chynom, fosforno kal'tsiievyy̆ obmin. Nedostatnia (gipoparatyreoz) abo nadlyshkova (giperparatyreoz) funktsiia pryshchytopodibnykh zaloz ie shkidlyvymy dlia patsiientiv, vplyvaie na stan nervovoï ta sertsevo sudynnoï systemy. Pryshchytopodibni zalozy mozhut' nakopychuvaty izotopy tseziiu, strontsiiu i radioaktyvnogo y̆odu. Otrymani dani svidchat' pro pidvyshchennia chastoty klinichno znachushchykh giperplaziy̆ pryshchyto podibnykh zaloz (ponad 9 mm u doroslykh, bil'she 5 mm u ditey̆) sered oprominenykh osib vnaslidok avariï na ChAES (28,64 %) ta ïkh nashchadkiv (23,8–70,6 %), persh za vse tykh, iaki meshkaiut' na zabrudnenykh terytoriiakh doroslogo viku v porivnianni z kontrol'noiu grupoiu (neopromineni – 24,15 %). Inshoiu grupoiu ryzyka buly evakuy̆ovani z 30 km zony vidchuzhennia – kategoriia osib, iaka zaznala diï poglynutykh izotopiv y̆odu v pershi dni avariï na ChAES.Tsi dani demonstruiut' chutlyvist' pryshchytopodibnykh zaloz do diï inkorporovanykh izotopiv (y̆odu, tseziiu i strontsiiu), shcho u viddaleni terminy oprominennia stvoriuiut' umovy dlia strukturno funktsional'nykh zmin u systemi reguliatsiïfosforno kal'tsiievogoobminu,iepidґruntiamdlia znachnoïposhyrenostiosteopeniïtaosteoporozuuop rominenykh osib ta ïkh nashchadkiv. Neobkhidno provesty nyzku doslidzhen' dlia podal'shogo utochnennia

Topics: 25-Hydroxyvitamin D 2; Adult; Bone Diseases, Metabolic; Calcium; Case-Control Studies; Chernobyl Nuclear Accident; Child; Female; Humans; Hyperplasia; Male; Osteoporosis; Parathyroid Glands; Phosphorus; Pilot Projects; Prospective Studies; Radiation Dosage; Radiation Exposure; Radiation, Ionizing; Radioisotopes; Survivors; Thyroid Gland; Ukraine; Ultrasonography

Decreased bone mineral density (BMD) was reported in HIV infected patients. Mechanisms leading to this decrease are poorly understood.. To assess factors relating to BMD in young HIV infected Israeli women of Ethiopian and Caucasian origin.. 75 young HIV infected women aged 34.5 ± 8.5 followed up at the Institute of Allergy, Clinical Immunology & AIDS filled a questionnaire about sun exposure, daily calcium intake and dress habits. Data about HIV status and treatment regimens were collected from the patients' charts. Serum hydroxyvitamin D [25(OH)D] levels, bone turnover markers and bone densitometry were evaluated.. 28 (65%) of Ethiopians and 2 (6.25%) of Caucasians had 25(OH)D serum levels <10 ng/ml (vitamin D deficiency), p = 0.001. 21 (67.7%) Ethiopians and 16 (39%) Caucasians avoided sun exposure, p = 0.019. Mean daily calcium intake was 491 ± 268.6 mg and 279 ± 252.6 mg, respectively, p = 0.001. Z scores < -1 found at Lumbar spine in 26 (89.7%), at Femoral neck in 20 (69%) at Total hip in 17 (58.6%) of vitamin D deficient patients compared to 20 (48.8%), 17 (41.5%), 9 (22%), in patients with 25(OH)D > 10 ng/ml, p < 0.01, <0.03, <0.001, respectively. Significantly more Ethiopian than Caucasian women covered their face (32.3% and 9.5%, p = 0.003) and hands (58.1% and 30.9%, p = 0.03). There was no difference in bone turnover markers levels.. Poorer vitamin D status was observed in Ethiopian women might be one of the important factors related to lower BMD in this group.

Topics: 25-Hydroxyvitamin D 2; Biomarkers; Bone and Bones; Bone Density; Bone Diseases, Metabolic; Calcifediol; Calcium, Dietary; Clothing; Diet; Ethiopia; Female; Follow-Up Studies; HIV Infections; Humans; Incidence; Israel; Middle Aged; Nutritional Status; Osteoporosis; Sunlight; Vitamin D Deficiency; White People

The aim of the study was to investigate the concentration of PGRN and other inflammatory cytokines TNF-α, IL-1β, IL-4, IL-6, IL-10, IL-13 and IL-17 in osteopenic and non-osteopenic obese subjects. Bone mineral density in subjects with different PGRN levels were compared to the appraisal of our hypothesis.. A total of 171 obese participants (BMI ≥30) were included in the study. Analysis of body composition was performed with use of Body Composition Analyzer. All blood samples were collected between 8:00 and 10:00 a.m. following an overnight fasting. The circulating levels of TNF-α, PGRN, IL-1β, IL-4, IL-6, IL-10, IL-13, IL-17, PTH, 25-Hydroxy Vitamin D and crosslaps were measured with the EIA method. BMD was measured by use of dual energy X-ray absorptiometery (DXA) at lumbar spine (vertebrae L2-L4) and hip level. Participants were categorized into osteopenic and healthy group according to the World Health Organization (WHO) criteria. Of 171 participants, 51 (29.82 %) were osteopenic and 120 (70.17%) were healthy.. We found significantly higher concentrations of crosslaps, IL-17, IL-6, TNFα and IL-4 and lower concentrations of IL-13, IL-10, PGRN and free fat mass in osteopenic group. With raising the PGRN level, the concentrations of IL-13, IL-10 and 25-(OH) vitamin D were increased and the concentration of TNFα and IL-17 were decreased. Our results demonstrated that the density of bone at both sites of lumbar spine (L2-L4) and hip region was highest in 4th quartile and lowest in first quartile of categorized PGRN concentration. The bone status was gradually improved with raising the PGRN level in parallel at lumbar spine (L2-L4) and hip regions.. Based on the pathway of effect of TNFα on bone metabolism, it appears that PGRN acts on the bone with mechanisms involving TNFR signaling, disturbance and TNFα performance, similar to the results that have been found in animal model study.

Topics: 25-Hydroxyvitamin D 2; Adult; Biomarkers; Body Composition; Bone Density; Bone Diseases, Metabolic; Collagen; Female; Hip; Humans; Inflammation; Intercellular Signaling Peptides and Proteins; Interleukins; Iran; Lumbosacral Region; Male; Middle Aged; Obesity; Parathyroid Hormone; Peptide Fragments; Progranulins; Protein Precursors; Receptors, Tumor Necrosis Factor; Spine; Tumor Necrosis Factor-alpha; Young Adult

To compare biochemical variables, renal function and calcium and vitamin D intakes in euparathyroid and hyperparathyroid patients with primary osteoporosis and osteopenia and describe the measures necessary to normalize serum PTH in the patients with secondary hyperparathyroidism.. We reviewed the charts of normocalcemic patients with primary osteoporosis and osteopenia first seen during the years 1991-2003 and identified 75 with elevated serum PTH levels at baseline. These patients were compared to all the 143 euparathyroid patients first seen in 1998 and 1999. Patients were restudied after 1 year and we attempted to follow patients with secondary hyperparathyroidism until PTH levels became normal.. At baseline serum PTH, ionized calcium, inorganic phosphate, alkaline phosphatase, creatinine, a complete blood count and serum 25 hydroxy vitamin D were measured in the early morning fasting state. These tests were repeated at follow up.. In one-third of the hyperparathyroid patients, the standard baseline treatment failed to correct the secondary hyperparathyroidism necessitating extraordinary measures including unusually large doses of vitamin D (i.e. 50 000 IU vitamin D(2) twice weekly) or the substitution of calcium citrate for calcium carbonate as a calcium supplement.. Large doses of vitamin D are frequently necessary to suppress secondary hyperparathyroidism in patients with primary osteoporosis and osteopenia. This suggests that vitamin D metabolism may be altered in some of these patients.

Topics: 25-Hydroxyvitamin D 2; Alkaline Phosphatase; Bone Diseases, Metabolic; Calcium; Calcium Citrate; Calcium, Dietary; Cholecalciferol; Creatinine; Female; Humans; Hyperparathyroidism, Secondary; Osteoporosis; Parathyroid Hormone; Phosphates; Retrospective Studies; Vitamin D

Chronic diseases in children may determine limited sun exposure, use of drugs, and other risk factors of osteopenia.. To evaluate vitamin D deficiency and their risk factor, in children with chronic diseases with suspected osteopenia.. We measured bone mineral density, bone remodeling markers, calcium, phosphate, parathormone, and 25 hydroxyvitamin D levels, and wrist X-ray.. We found 8 children of 25 with suspected osteopenia, with biochemical abnormalities suggestive of vitamin D deficiency. All children had low levels of 25 hydroxyvitamin D, 5 had reduced bone mineral density, 4 had hyperparathyroidism, 2 had hyperphosphatasemia, and 1 hypocalcemia and hypophosphatemia. None had rickets.. Osteopenia in chronic sick children is due to multiple factors; however, vitamin D deficiency is a preventable disorder. We recommend that all children with a chronic disease with risk factors for vitamin D deficiency should be monitored with 25 hydroxyvitamin D serum levels.

Topics: 25-Hydroxyvitamin D 2; Adolescent; Bone Diseases, Metabolic; Child; Child, Preschool; Chile; Chronic Disease; Female; Humans; Male; Risk Factors; Vitamin D Deficiency

Topics: 25-Hydroxyvitamin D 2; Absorption; Animals; Bone and Bones; Bone Density; Bone Diseases, Metabolic; Calcium; Cell Count; Cyclic AMP; Gastrectomy; Gastric Mucosa; Gastritis; Humans; Hydrogen-Ion Concentration; Male; Phosphorus; Rats; Rats, Sprague-Dawley; Urine

The bone mineral density of the lumbar spine was assessed in nine non-ambulant children with cerebral palsy combined with measurements of serum 25-hydroxyvitamin D, parathyroid hormone, and urinary calcium excretion. Three children with recurrent fractures received treatment with bisphosphonates for periods ranging from 12-18 months. All the children demonstrated a severe reduction in bone mineral density even when allowance was made for their body weight. There were no consistent abnormalities of vitamin D or parathyroid hormone status. Three children had gross hypercalciuria. Each of the children treated with bisphosphonates demonstrated an increment in bone density ranging from 20-40% with no apparent adverse effects.

Topics: 25-Hydroxyvitamin D 2; Adolescent; Bone Density; Bone Diseases, Metabolic; Calcifediol; Calcium; Cerebral Palsy; Child; Child, Preschool; Diphosphonates; Female; Fractures, Bone; Humans; Lumbar Vertebrae; Male; Parathyroid Hormone

Fifteen female patients with primary biliary cirrhosis were evaluated for vitamin D status and evidence of metabolic bone disease. Full-thickness iliac crest bone biopsy specimens with histomorphometric analysis after double tetracycline labeling were performed before and after 1 yr of treatment with oral 25-hydroxyvitamin D (100 micrograms/day). Initially, serum 25-hydroxyvitamin D levels were low (less than 15 ng/ml) in 11 of the 15 patients and were increased to normal (greater than 25 ng/ml) in all patients within 3 mo. Serum parathyroid hormone levels were low normal or not detectable in all patients and did not change with therapy. No patient had a fracture during the treatment. No evidence of osteomalacia was found initially or in follow-up study in any patient. Follow-up histomorphometric analysis at the end of the 1-yr treatment showed that bone volume decreased during the study interval despite therapy (p less than 0.001). Photon beam densitometry confirmed the loss in trabecular density of the radius over the study interval (p less than 0.03). The mean fractional osteoid surface was not increased initially and did not change with therapy. The mean linear bone appositional rate as measured by double tetracycline labeling was not decreased initially and did not change with therapy. It was concluded that in moderate to severe primary ciliary cirrhosis, initial 25-hydroxyvitamin D levels are low and are rapidly corrected by oral 25-hydroxyvitamin D. These patients have significant osteoporosis which progresses despite 25-hydroxyvitamin D.

Topics: 25-Hydroxyvitamin D 2; Adult; Bone and Bones; Bone Diseases, Metabolic; Ergocalciferols; Female; Humans; Liver Cirrhosis, Biliary; Middle Aged

The prevalence of vitamin D deficiency in Crohn's disease and the relationship of vitamin D status to metabolic bone disease have not been fully characterized. Serum 25-hydroxyvitamin D was measured in 82 patients with Crohn's disease; 65% of Crohn's disease patients had a low serum 25-hydroxyvitamin D concentration; 25% had deficient levels (less than 10 ng/ml). The lowest 25-hydroxyvitamin D levels were observed in patients with previous ileal resections. Nine patients were studied in detail including transiliac needle bone biopsies; 6 had osteomalacia and 3 osteoporosis. Six patients had repeat bone biopsies 9 to 18 mo after vitamin D treatment. Three patients with osteomalacia and low serum 25-hydroxyvitamin D levels showed histologic improvement after therapy with oral vitamin D restored serum 25-hydroxyvitamin D levels to normal. The adequacy of therapy was assessed accurately by monitoring serum 25-hydroxyvitamin D concentration. Three patients with metabolic bone disease with normal serum 25-hydroxyvitamin D levels at diagnosis did not show histologic improvement after receiving vitamin D.

Topics: 25-Hydroxyvitamin D 2; Adult; Aged; Bone and Bones; Bone Diseases, Metabolic; Crohn Disease; Ergocalciferols; Female; Humans; Male; Middle Aged; Osteomalacia; Vitamin D; Vitamin D Deficiency

Patients receiving long term parenteral nutrition may develop metabolic bone disease. In all 11 patients studied, histologic studies of bone showed excessive unmineralized bone tissue despite normal plasma 25-hydroxyvitamin D levels. Three patients also had bone pain and fractures and severe urinary loss of calcium and phosphate. Withdrawal of vitamin D from parenteral nutrition solutions was associated with improved histologic findings of bone in all patients, shown by a decrease in osteoid tissue and an increase in tetracycline uptake. In the three patients with symptoms, bone pain subsided, fractures healed, and urinary loss of calcium and phosphate decreased. Thus, vitamin D may be a factor in the genesis of parenteral nutrition-induced metabolic bone disease.

Topics: 25-Hydroxyvitamin D 2; Adult; Bone and Bones; Bone Diseases, Metabolic; Calcium; Dihydroxycholecalciferols; Ergocalciferols; Female; Fluorides; Humans; Male; Middle Aged; Osteomalacia; Parenteral Nutrition; Parenteral Nutrition, Total; Phosphates