ICCBH2015 Poster Presentations (1) (201 abstracts)
1Institute of Orthopedics and Traumatology, National Academy of Medical Sciences, Kyiv, Ukraine; 2Childrens Bone and Spine Surgery, Las-Vegas, Nevada, USA.
Objective: Bone metabolism was studied in patients with phosphate diabetes before and after medication.
Methods: 39 patients with phosphate diabetes age 218 years (7.8±4 years, 64% male) and multiplanar deformities of the lower extremities were treated with monthly vitamin D (2000 IU/day), alfacalcidol (0.25 mg/every other day) and calcium glycerophosphate (600 mg/day) for 6 months.
Biochemical indices were evaluated before (n=39) and after treatment (n=5), Table 1.
Results: After treatment, 25-hydroxy vitamin D increased 2.12 times (P<0.05), 1,25-dihydroxy vitamin D increased 1.8 times (P<0.05), and osteocalcin decreased in two times (P<0.05).
Strong correlations were observed only between 25-hydroxy vitamin D and 1,25-dihydroxy vitamin D (Table 2).
After treatment, positive correlations were seen between Ca and Ca+, Ca+ and 1,25-dihydroxy vitamin D, 25-hydroxy vitamin D and osteocalcin, 25-hydroxy vitamin D and B-CTx, 1,25 dihydroxy vitamin D and P1NP, urinary calcium and urinary phosphate, B-CTx and osteocalcin. Negative correlations were observed between PTH and 1,25-dihydroxy vitamin D, PTH and B-CTx, urinary phosphate and osteocalcin, B-CTx and urinary phosphate. (Table 3)
Indicators of bone metabolism/stages of treatment | Before treatment | After treatment |
Ionized calcium | 1.21±0.01 | 1.25†±0.02 |
Serum phosphate | 0.62±0.03 | 0.67±0.07 |
Calcium | 2.34±0.02 | 2.44†±0.03 |
25(OH)2D | 19.30±2.01 | 40.97*±7.07 |
1,25(OH)2D | 74.15±3.89 | 134.60*±13.39 |
PTH | 48.66±4.59 | 39.01±12.86 |
Osteocalcin | 123.35±10.27 | 59.11*±34.05 |
Urinary calcium (daily) | 2.42±0.25 | 2.54±0.94 |
Urinary phosphate (daily) | 34.09±1.36 | 26.52†±3.15 |
P1NP | 815.03±59.86 | 576.4±205.65 |
B-CTx | 2.16±0.11 | 1.69±0.46 |
*Significant difference treatment P<0.05. †Trend close to significant, 0.1> P>0.05. |
Ca+ | P | Ca | 25(OH)2D | 1,25(OH)2D | PTH | Osteocalcin | Urine calcium (daily) | Urine phosphor (daily) | P1NP | B-CTx | |
Ca+ | 1.00 | 0.16 | 0.24 | 0.04 | 0.03 | 0.06 | 0.06 | 0.27 | −0.02 | 0.35 | 0.02 |
P | 0.16 | 1.00 | 0.25 | 0.27 | 0.24 | 0.07 | 0.19 | −0.04 | −0.63 | 0.04 | 0.04 |
Ca | 0.24 | 0.25 | 1.00 | 0.23 | 0.52 | −0.38 | −0.13 | −0.18 | −0.42 | 0.24 | −0.09 |
25(OH)2D | 0.04 | 0.27 | 0.23 | 1.00 | 0.80 | −0.34 | −0.01 | −0.30 | −0.13 | 0.06 | 0.23 |
1,25(OH)2D | 0.03 | 0.24 | 0.52 | 0.80 | 1.00 | −0.39 | −0.38 | −0.31 | −0.34 | −0.04 | 0.05 |
PTH | 0.06 | 0.07 | −0.38 | −0.34 | −0.39 | 1.00 | −0.32 | 0.49 | 0.37 | −0.36 | −0.62 |
osteocalcin | 0.06 | 0.19 | −0.13 | −0.01 | −0.38 | −0.32 | 1.00 | −0.02 | −0.19 | 0.52 | 0.60 |
urine calcium (daily) | 0.27 | −0.04 | −0.18 | −0.30 | −0.31 | 0.49 | −0.02 | 1.00 | 0.41 | 0.27 | −0.01 |
urine phosphor (daily) | −0.02 | −0.63 | −0.42 | −0.13 | −0.34 | 0.37 | −0.19 | 0.41 | 1.00 | −0.13 | −0.18 |
P1NP | 0.35 | 0.04 | 0.24 | 0.06 | −0.04 | −0.36 | 0.52 | 0.27 | −0.13 | 1.00 | 0.74 |
B-CTx | 0.02 | 0.04 | −0.09 | 0.23 | 0.05 | −0.62 | 0.60 | −0.01 | −0.18 | 0.74 | 1.00 |
Correlations (marc vdrr.sta). Marked correlations are significant at P<0.05000. n=39 (Casewise deletion of missing data). |
Ca+ | P | Ca | 25(OH)2D | 1,25(OH)2D | PTH | Osteocalcin | Urine calcium (daily) | Urine phosphor (daily) | P1NP | B-CTx | |
Ca+ | 1.00 | 0.11 | 0.85 | −0.35 | 0.86 | −0.50 | 0.28 | 0.61 | 0.06 | 0.48 | 0.03 |
P | 0.11 | 1.00 | −0.37 | −0.60 | −0.12 | 0.69 | 0.28 | 0.70 | 0.59 | 0.18 | −0.53 |
Ca | 0.85 | −0.37 | 1.00 | −0.16 | 0.75 | −0.70 | −0.23 | 0.18 | −0.25 | 0.24 | 0.16 |
25(OH)2D | −0.35 | −0.60 | −0.16 | 1.00 | 0.16 | −0.57 | 0.90 | −0.66 | −0.68 | 0.40 | 0.92 |
1,25(OH)2D | 0.86 | −0.12 | 0.75 | 0.16 | 1.00 | −0.79 | 0.18 | 0.38 | −0.21 | 0.75 | 0.52 |
PTH | −0.50 | 0.69 | −0.70 | −0.57 | −0.79 | 1.00 | −0.41 | 0.20 | 0.56 | −0.50 | −0.78 |
Osteocalcin | −0.28 | −0.28 | −0.23 | 0.90 | 0.18 | −0.41 | 1.00 | −0.56 | −0.75 | 0.64 | 0.89 |
Urine calcium (daily) | 0.61 | 0.70 | 0.18 | −0.66 | 0.38 | 0.20 | −0.56 | 1.00 | 0.77 | 0.18 | −0.46 |
Urine phosphor (daily) | 0.06 | 0.59 | −0.25 | −0.68 | −0.21 | 0.56 | −0.75 | 0.77 | 1.00 | −0.41 | −0.75 |
P1NP | 0.48 | 0.18 | 0.24 | 0.40 | 0.75 | −0.50 | 0.64 | 0.18 | −0.41 | 1.00 | 0.68 |
B-CTx | 0.03 | −0.53 | 0.16 | 0.92 | 0.52 | −0.78 | 0.89 | −0.46 | −0.75 | 0.68 | 1.00 |
Correlations (marc vdrr.sta). Marked correlations are significant at P<0.05000. n=5 (Casewise deletion of missing data). |
Conclusions: The medication protocol improves bone metabolism with phosphate diabetes, reduces osteomalacia, and improves ratios of bone formation and bone resorption.
Disclosure: The authors declared no competing interests.