These findings justify the need to assure adequate vitamin D intake in patients being treated with anticonvulsants, independently of the treatment, age, sex, and activity status, in order to prevent osteomalacia.

No abstract

Study design: A cross-sectional study. Objective: To clarify the existing controversy with regard to whether paraplegic patients suer a loss of bone mass in the upper limbs. Setting: Madrid, Spain. Methods: We evaluated bone mass by phalangeal ultrasonography in 35 male patients with paraplegia (mean age 49+12 years), and 25(OH)D3 and PTH to exclude the presence of osteomalacia and secondary hyperparathyroidism. Spasticity was evaluated according to the Ashworth scale. Patients were compared with a control group of 35 healthy male subjects (mean age 48+13 years). Results: The patients had lower 25(OH)D 3 levels and amplitude-dependent speed of sound (Ad-SOS) than controls (both P50.001), and higher PTH levels (P50.05). There was a statistically signi®cant negative association between PTH and 25(OH)D 3 levels (r=70.52, P50.0001, CI 70.73 to 70.22) and between 25(OH)D 3 and injury duration (r=0.34, P50.05, CI 70.60 to 70.01). There was no correlation between Ad-SOS values, levels of PTH or 25(OH)D 3 , and the injury duration. No signi®cant dierence in Ad-SOS values was found in patients grouped according to low-to-normal 25(OH)D 3 level or according to normal-to-high PTH level. There were no dierences in relation to muscle tone. Only alkaline phosphatase and tartrate-resistant acid phosphatase levels were higher in patients than in controls (both P50.001). Conclusion: Paraplegic patients had a loss of phalangeal bone mass that was unrelated to the levels of vitamin D or PTH, or to muscle tone, so it seems to be related to increased bone resorption rather than to de®cient bone formation.

In patients with CD, gluten-free diet and increased nutritional intake were accompanied by normal bone mass values as determined by ultrasound on phalanges.

Aims: The influence of eating habits on bone mass is a controversial topic. We have use ultrasound to search for the relationships between nutrients and bone density. Methods: A total of 228 women (mean age 48.9 ± 13.7 years) were studied, and divided according to their gonadal status (pre-, peri- and postmenopausal women). The dietary intake was recorded for 7 days, and their bone mass was measured by phalangeal amplitude-dependent speed of sound (Ad-SOS). ANOVA was made to examine the differences according to gonadal status. To determine the possible correlation between Ad-SOS and nutrient intake, partial correlations, adjusted for important confounding variables, were done. Results: With partial correlations, there was no correlation of Ad-SOS with the nutrients studied here. Conclusion: We find no correlation of bone mass as measured by Ad-SOS with the most common nutrients and trace minerals, either for the participants as a whole or according to gonadal status.