Retracted: Abnormal bone and calcium metabolism in immobilized Parkinson's disease patients

Abstract

To elucidate the influence of immobilization-induced hypercalcemia on bone metabolism in Parkinson's disease (PD), we measured serum biochemical indexes and bone mineral density (BMD) in the second metacarpals of 142 elderly PD patients and 99 age-matched healthy controls. Serum concentrations of 25-hydroxyvitamin D (25-OHD), 1,25-dihydroxyvitamin D (1,25-[OH](2)D), ionized calcium, intact parathyroid hormone (PTH), and intact bone Gla protein (BGP) were measured. Urinary deoxypyridinoline (D-Pyr) was also measured. Increased serum calcium levels (mean, 1.27 mmol/L) were observed in PD patients, and the levels correlated negatively with the Unified Parkinson's Disease Rating Scale III (UPDRS III), indicating the presence of immobilization-induced bone resorption with resultant hypercalcemia. Decreased serum concentrations of 1,25-[OH](2)D (mean, 88.7 pmol/L) and 25-OHD (mean, 29.7 nmol/L) were noted. Serum PTH was decreased (mean, 25.2 ng/L). Serum BGP was decreased while urinary D-Pyr concentration elevated. A negative correlation was observed between 1,25-[OH](2)D levels and serum calcium or UPDRS III (P < 0.0001). In disabled PD patients, immobilization-induced hypercalcemia may inhibit secretion of PTH, which in turn suppresses 1,25-[OH](2)D production. 25-OHD insufficiency may also contribute to decreased 1,25-[OH](2)D. These abnormalities may be corrected by the suppression of bone resorption with bisphoshonate, and supplementations of calcium and vitamin D should be avoided in these patients.

Association of vitamin D receptor gene polymorphisms and Parkinson's disease in Hungarians

“…The level of vitamin D in PD has been analysed in number of studies. A Japanese population exhibited a higher incidence of hip fractures and lower serum levels of 25OHD in PD patients as compared with the healthy controls [34,35], observations that were confirmed in a Caucasian population [9]. The serum 25OHD level correlated negatively with the severity of PD, measured in terms of the Hoehn &Yahr stage and the Unified Parkinson's Disease Rating Scale (UPDRS) [34][35][36].…”

“…Whereas Sato et al [34] reported a negative correlation between the 1,25OHD level and the UPDRS score, Suzuki et al [36] could not confirm this finding.…”

“…Caucasian populations [9,34,35] and demonstrated a higher incidence of osteoporosis in PD patients of both genders, with a decreased bone mass index and a reduced bone mineral density [11,34]. Overall, it has been clearly shown that the vitamin D metabolism is affected in PD patients.…”

Joint Replacement Surgery in Parkinson's Disease

“…Table 1. Recommended assessment of the patient with Parkinson's disease (Mason et al 1996) population (Kao et al 1994;Sato et al 1997;Fink et al 2005;Sato et al 2005). Patients with Parkinson's disease tend to be less active than patients without the disease, and lack of sunlight absorption makes these patients more likely to be ostopenic.…”

“…Patients with PD are also reported to have abnormal bone metabolism (Sato et al 2005) resulting from reduced parathyroid hormone. Recent studies using teriparatide, a recombinant human parathyroid hormone, for the treatment of reduced BMD are showing promising results (Aspenberg et al 2010;Ma et al 2011;Moricke et al 2011) but so far none of the studies are related to patients with PD.…”