Vitamin D insufficiency and the blunted PTH response in established osteoporosis: the role of magnesium deficiency

Sahota, O.; Mundey, M K; San, P.; Godber, Ian M; Hosking, D. J.

doi:10.1007/s00198-006-0219-6

Cited by 44 publications

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“…We were surprised to find that PTH(i) levels remained unchanged in our subjects. Hypomagnesemia blunts the PTH(i) response and might be one possible explanation for our finding [37]. Adewoye and coworkers have reported that patients with sickle cell anemia have low red cell and plasma magnesium levels [38,39].…”

Section: Discussionmentioning

confidence: 75%

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Sickle cell bone disease: Response to vitamin D and calcium

Adewoye

Chen

et al. 2007

American J Hematol

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Bone disease with osteoporosis and osteomalacia are common in sickle cell disease (SCD). Some patients have vitamin D deficiency and low bone mineral density (BMD). The role of vitamin D and calcium supplementation to restore bone health in SCD has not been well studied. In 14 adults with SCD, we measured 25(OH)D (25-hydroxyvitamin D) and BMD at the femoral neck, lumbar spine, and distal third of the ulna plus radius, along with markers of bone resorption (CTx; C-terminal component of pro-collagen type I) and bone formation (osteocalcin) before and after 12 months of vitamin D 2 and calcium carbonate treatment. Pretreatment, all patients were vitamin D deficient with a mean 25(OH)D level of 10.7 ± 4.7 ng/ml, had low BMD at the lumbar spine (L-spine), 0.87 ± 0.11 g/cm 2 (mean Z-score of -2.6 3 ± 0.71 SD and T score of -2.31 ± 0.75 SD), femoral neck, 0.8 ± 0.18 g/cm 2 (mean Z-score -1.36 ± 0.84, T-score -1.14 ± 0.75), and the distal radius and ulna, 0.6 ± 0.17 g/cm 2 (mean Z-score -1.18 ± 0.79, T-score -1.01 ± 0.74) and had elevated CTx (0.87 ± 0.5 ng/ml) and osteocalcin levels (12.3 ± 3.7 ng/ll). After treatment, all patients corrected their 25(OH)D level (38.8 ± 13.9 ng/ml) (P < 0.001) with a 3.6% ± 3.9% increase in BMD at the L-spine (P 5 0.009), 4.6% ± 8.5% increase at the femoral neck (P 5 0.05) and 6.5% ± 12.6% increase at the distal radius plus ulna (P 5 0.09). CTx, osteocalcin, and PTH(i) levels were unchanged. Treatment of adult SCD with vitamin D and calcium can restore 25(OH)D levels to normal and improve BMD, but, markers of bone resorption remained unchanged. Screening for vitamin D deficiency and BMD in SCD patients seems warranted. Am. J. Hematol. 83:271-274, 2008. V

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Section: Discussionmentioning

confidence: 75%

“…Adewoye and coworkers have reported that patients with sickle cell anemia have low red cell and plasma magnesium levels [38,39]. Clinical trials with magnesium loading might be required to evaluate this potential mechanism in SCD [37].…”

Section: Discussionmentioning

confidence: 99%

Sickle cell bone disease: Response to vitamin D and calcium

Adewoye

Chen

et al. 2007

American J Hematol

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“…Differences in vitamin D consumption and status may have also contributed. In adults with established osteoporosis, magnesium deficiency has been shown to blunt PTH response [20]. Although serum levels of this cation were not measured in the current study, this possibility is an important consideration in a malnourished group with AN.…”

Section: Discussionmentioning

confidence: 79%

Low prevalence of vitamin D deficiency among adolescents with anorexia nervosa

et al. 2007

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Summary-Fifty adolescents with AN and 200 healthy girls underwent vitamin D screening. Girls with AN reported exceptional compliance with vitamin D supplementation and PTH concentrations were lower. Vitamin D deficiency was less common in the group with AN, but when race was considered, the trend was no longer significant.Introduction-The objective of this study was to determine whether patients with anorexia nervosa (AN) are more compliant with supplementation and have a lower prevalence of vitamin D deficiency than healthy controls.

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“…It should be noted that the relation between the concentrations of PTH and the concentrations of 25VTD is probably dependant on the magnesium status of the subjects tested. Indeed, a relative hypomagnesemia is able to explain why PTH does not rise, even if the patient is clearly vitamin D insufficient (25).…”

Section: Vitamin D Deficiency and ''Desirable'' Serum Valuesmentioning

confidence: 99%

Vitamin D: current status and perspectives

Cavalier

Chapelle

Souberbielle

2009

Clinical Chemistry and Laboratory Medicine

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The role of vitamin D in maintaining bone health has been known for decades. Recently, however, the discovery that many tissues expressed the vitamin D receptor and were able to transform the 25-OH vitamin D into its most active metabolite, 1,25-(OH) 2 vitamin D, has led to a very promising future for this ''old'' molecule. Indeed, observational studies, and more and more interventional studies, are raising the importance of a significant vitamin D supplementation for not-only skeletal benefits. Among them, 25-OH vitamin D has been found to play an important role in prevention of cancers, auto-immune diseases, cardiovascular diseases, diabetes, and infections. Vitamin D deficiency, defined as serum 25-OH vitamin D levels -30 ng/mL, is very common in our population. The cost/benefit ratio and some recently published studies are clearly now in favor of a controlled and efficient vitamin D supplementation in these patients presenting a 25-OH vitamin D level -30 ng/mL. More attention should also be focused on pregnant and lactating women, as well as children and adolescents. Clin Chem Lab Med 2009;47:120-7.

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Vitamin D insufficiency and the blunted PTH response in established osteoporosis: the role of magnesium deficiency

Abstract: Due to errors on the part of the typesetter, the article was published with incorrect versions of the column heads of Table 1 and the illustration and legend of Fig. 2. The correct table and figure are given in full here.

Cited by 44 publications

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Sickle cell bone disease: Response to vitamin D and calcium

Sickle cell bone disease: Response to vitamin D and calcium

Low prevalence of vitamin D deficiency among adolescents with anorexia nervosa

Vitamin D: current status and perspectives

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