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1.
‘Intact’ parathyroid hormone (iPTH) assays are used to measure serum PTH levels in haemodialysis patients to diagnose and
monitor secondary hyperparathyroidism and consequent renal osteodystrophy (ROD); these assays exhibit cross-reactivity with
long carboxyl-terminal PTH fragments (C-PTH) that accumulate in end stage renal failure (ESRF) and antagonise the biological
activity of the whole molecule, 1–84 PTH. The effects of haemodialysis on C-PTH are not known. We investigated how haemodialysis
affects serum concentrations of calcium, iPTH, 1–84 PTH, C-PTH, and other markers of bone turnover; bone-specific alkaline
phosphatase (BALP) and type 1 collagen cross-linked telopeptide (CTx). Fifteen patients, mean (range) age 13.9 (4.3–17.6)
years, haemodialysed for a median of 16.3 (4–41) months, had pre- and post-dialysis serum samples collected for routine biochemistry,
BALP, CTx, iPTH and 1–84 PTH assays. Changes to serum concentrations and relationships between these biochemical surrogate
markers of ROD were investigated. Serum phosphate and PTH levels (measured by both assays) fell significantly during dialysis,
whereas serum calcium, C-PTH, the 1–84 PTH: C-PTH ratio and BALP and CTx concentrations were not significantly changed. 1–84
PTH levels were related to pre but not post dialysis serum calcium levels and changes to 1–84 PTH levels during dialysis were
related to changes in serum calcium levels. 1–84 PTH and iPTH were reduced by haemodialysis, whereas levels of BALP and CTx
remained stable post-dialysis. The relationship between BALP and CTx and bone histology requires investigation to determine
whether they are more useful markers of bone turnover in this patient group. 相似文献
2.
Barbara P. Lukert M.D. Mary Carey Barbara McCarty Susan Tiemann Lucinda Goodnight Malinda Helm Ruth Hassanein Charlotte Stevenson Mary Stoskopf Linda Doolan 《Calcified tissue international》1987,40(3):119-125
Summary The relationships between nutritional factors, calcium regulating hormones, and bone density were evaluated in three groups
of normal subjects in rural southeast Kansas. Dietary intake of calcium (Ca), phosphorous (P), protein, and vitamin D; and
serum 25OHD, Ca, P, parathyroid hormone (iPTH), and bone density (distal 1/3 radius) were measured in 29 elderly women, 35
elderly men, and 50 perimenopausal women. Measurements were repeated 5 years and 4 years later respectively in 16 elderly
women and 15 elderly men. The r values for significant regression correlations for each group were as follows: perimenopausal:
bone density and dietary Ca:P−r=.29, iPTH and 25OHD−r=−.38; elderly women: 25OHD and dietary Vitamin D(D)−r=.58, change in
bone density (ΔBD) and initial bone density (BDI)−r=−.71, ΔBD and serum 25OHD−r=−.60, serum calcium and age−r=−.42; elderly
men: Serum 25OHD and D−r=.61, iPTH and 25OHD−r=−.43, iPTH and serum phosphorous−r=.59. Conclusions: (1) The more adequate
the state of vitamin D nutriture, the lower the serum iPTH in perimenopausal women and elderly men and the less bone loss
in elderly women. (2) The Ca:P ratio in the diet may be important in maintaining bone density in perimenopausal women. 相似文献
3.
Haden ST Fuleihan GE Angell JE Cotran NM LeBoff MS 《Calcified tissue international》1999,64(4):275-279
We performed a retrospective study of 237 patients attending a specialty osteoporosis practice. Secondary causes for reduced
bone mineral density (BMD) were evaluated in 196 postmenopausal women and 41 premenopausal women; mean age was 56 ± 13.8 years
(mean ± SD). BMD was measured by dual-energy X-ray absorptiometry (DXA) (QDR 1000W/2000 Hologic). Levels of intact parathyroid
hormone (iPTH), calcidiol [25(OH)D], thyroid-stimulating hormone, and 24-hour urinary calcium were measured, and serum and
urine protein (SPEP and UPEP) electrophoresis were performed. Overall, 16% of our patients had 25(OH)D levels <15 ng/ml, the
lowest acceptable vitamin D level without a concomitant rise in iPTH levels. Among the osteoporotic patients (T score <−2.5
SD), 17% had 25(OH)D levels <15 ng/ml and 7% <10 ng/ml. Among the osteopenic patients (−2.5 < T < −1.0 SD), 11% had 25(OH)D
levels <15 ng/ml. Seventeen percent of patients with Z score ≤−1.0 SD (low range normal value) had 25(OH)D levels <15 ng/ml.
Low 25(OH)D levels were inversely related to high iPTH values (r = 0.30, P < 0.0001). Hypercalciuria was present in 15% of our patients, elevations of PTH levels (>65 pg/ml, upper normal limit of
assay) were present in 11.5%, and hyperthyroidism in 4%. A 25(OH)D level of <25 ng/ml in women (n = 86) with no known secondary causes of low BMD was associated with an iPTH level above 49 pg/ml. The measurement of 25(OH)D levels is recommended in the evaluation of secondary
causes for reduced BMD. Supplementation with vitamin D appears needed to keep 25(OH)D above 25 ng/ml, the level required to
prevent increments in iPTH levels.
Received: 9 February 1998 / Accepted: 1 October 1998 相似文献
4.
Background Laparoscopic gastric bypass, currently the most popular surgical method for bariatric therapy, have proved to be effective
in weight loss, but some matters regarding its long-term efficacy for super-obese patients (BMI >50 kg/m2) have arisen. Biliopancreatic diversion (BPD) is a complex technique that has shown good results in the treatment of the
super-obese patient. We analyze our >5 years results, evaluating weight loss, morbidity and mortality of this operation, depending
on the length of the common and alimentary limbs.
Methods We studied two series of patients: 150 patients with BPD of Scopinaro (50–200 cm) and 70 patients with modified BPD (75–225 cm).
The results have been analyzed in terms of weight loss, co-morbidity improvement, and postoperative morbidity using BAROS.
Results Range of follow-up is 1–12 years. Weight loss was slightly higher for the Scopinaro group than for the Modified group but
with no significant difference. There was more prevalence of malnutrition and of iron deficiency in the Scopinaro group (16%
and 60%) than in the modified group (2% and 40%), with similar postoperative morbidities.
Conclusion The modified BPD method (75–225 cm) shows long-term effectiveness in weight loss and comorbidity improvement for super-obesity.
Proteins, vitamins and oligoelement deficits appear distant in time, and thus it is necessary to maintain strict followup
of these patients and supplement against deficiencies for the rest of their lives. 相似文献
5.
Data on the association between dietary vitamin K intake and fracture risk are limited among Chinese. This study examined
such an association in community-dwelling elderly in Hong Kong. We present data from 2,944 subjects (1,605 men, 1,339 women)
who participated in a prospective cohort study. Baseline dietary intakes of energy, protein, calcium, vitamin D, and vitamin
K were assessed using a food-frequency questionnaire. Data on incident hip fracture and nonvertebral fracture during a median
of 6.9 follow-up years were collected from a hospital database. Cox regression analyses were performed with adjustments for
age, education attainment, smoking status, alcohol use, body mass index, hip bone mineral density, physical activity, use
of calcium supplement, and energy-adjusted nutrient intakes. There were 29 (1.8 %) men and 19 (1.4 %) women with incident
hip fractures and 97 (6.0 %) men and 88 (6.6 %) women with nonvertebral fractures. The median (interquartile range) of dietary
vitamin K intake was 241.8 (157.5–360.8) and 238.9 (162.4–343.6) μg/day in men and women, respectively. Similar dietary vitamin
K intakes were observed between subjects with hip or nonvertebral fractures and subjects without hip or nonvertebral fractures.
In both men and women, dietary vitamin K intake was not associated with fracture risks at all measured sites in either crude
or adjusted models. In Chinese community-dwelling elderly, hip or nonvertebral fracture risk was not associated with dietary
vitamin K intake. The high dietary vitamin K intake of the studied group may have limited the ability to detect the association
between vitamin K intake and fracture risk. 相似文献
6.
Background Bone disease has been described in patients after surgical treatment for obesity, but few studies have dealt with the impact
of vertical banded gastroplasty on mineral metabolism. We have examined bone mineral metabolism in morbidly obese patients
before and after 3 months after vertical banded gastroplasty without vitamin D supplementation.
Methods Sixteen morbidly obese patients (14 women, 2 men) with a mean (±SD) age of 38 ± 9 years and a body mass index (BMI) of 47.1 ± 8.1 kg/m2 were studied. No vitamin D supplementation was given. Body weight, fat mass, calcium, 25OHD, iPTH, bone remodeling markers,
and leptin levels were measured at baseline and after weight loss.
Results Mean weight loss was 28 ± 11 kg; BMI and body fat mass decreased by 20 and 35%, respectively. Bone resorption markers and
albumin-corrected serum calcium increased after operation, whereas iPTH fell. Serum 25OHD levels rose. Leptin levels decreased.
Serum iPTH was positively correlated with weight, BMI, and fat mass before operation (p < 0.05), and its decline after weight reduction was negatively associated with the increase in bone resorption markers (p < 0.01). Leptin concentration was correlated with BMI and body fat mass (p < 0.05) both before and after surgery.
Conclusions Weight reduction obtained in morbidly obese subjects 3 months after vertical banded gastroplasty increases bone turnover markers
and decreases PTH secretion. Serum 25OHD levels rose. Therefore, no reasons for a metabolic bone disease related to hypovitaminosis
D were readily apparent. However, an increase in bone turnover, which is generally regarded as a potential risk factor for
osteoporosis, was observed. Further work is needed to clarify the importance of this turnover increase in the long run. 相似文献
7.
J. E. P. Rockell C. M. Skeaff S. M. Williams T. J. Green 《Osteoporosis international》2006,17(9):1382-1389
Introduction Vitamin D plays an important role in bone health. Our purpose was to measure serum 25-hydroxyvitamin D concentrations and their determinants in a national sample (n=2,946) of New Zealanders aged 15 years and over.Findings Mean (99% CI) serum 25-hydroxyvitamin D concentrations were 47 (45–50) nmol/l in women and 52 (49–55) nmol/l in men. Mean concentrations in New Zealand European and Others (NZEO, n=2,440), Mori (n=370), and Pacific (n=136) were 51 (49–53), 42 (38–46) and 37 (33–42) nmol/l, respectively. Three percent of New Zealanders had serum 25-hydroxyvitamin D concentrations indicative of deficiency (≤17.5 nmol/l); 48% and 84% were insufficient based on cutoffs of ≤50 and ≤80 nmol/l. Determinants of serum 25-hydroxyvitamin D concentrations in women were age, ethnicity, obesity, latitude and season; determinants in men were ethnicity and season. Serum 25-hydroxyvitamin D in women declined with age; mean concentration was 13 (8–18) nmol/l lower in women 65 years or older and 9 (5–13) nmol/l lower in women 45–64 years compared with women 15–18 years. Spring to summer differences in serum 25-hydroxyvitamin D were 31 (28–34) and 28 (25–31) nmol/l in women and men, respectively. Obese women had lower vitamin status than normal-weight women by 6 (3–10). Women living in the South Island had a mean serum 25-hydroxyvitamin D that was 6 (3–9) nmol/l lower than women living in the North Island. Ethnicity and season are the major determinants of serum 25-hydroxyvitamin D in New Zealanders.Conclusion The high prevalence of vitamin D insufficiency in New Zealanders, particularly in older women, may warrant strategies to improve vitamin D status. 相似文献
8.
We studied the prevalence of poor vitamin D status and the association with bone density in men and women born in Norway (quoted as Norwegians, n = 869) and Pakistan (quoted as Pakistanis, n = 177) in the population-based Oslo Health Study, 2000-2001. We measured 25-hydroxyvitamin D, iPTH and ionized calcium in serum and bone mineral density at the forearm site with single energy X-ray absorptiometry. Mean 25-hydroxyvitamin D was 74.8 +/- 23.7 nmol/l in the Norwegians and 25.0 +/- 13.6 nmol/l in the Pakistanis (P = 0.000). The prevalence of secondary hyperparathyroidism (iPTH > or = 8.5 pmol/l, 25-hydroxyvitamin D < 50 nmol/l and Ca2+ < or = 1.35 mmol/l) was four times higher in Pakistani compared to Norwegian women. Also in Pakistani men, serious vitamin D deficiency defined as secondary hyperparathyroidism was prevalent, and five times as frequent as in Norwegian men. However, whereas BMD was significantly lower in Norwegian women with, compared to Norwegian women without, secondary hyperparathyroidism, there was no difference in BMD between Pakistani women with and without secondary hyperparathyroidism. In conclusion, vitamin D deficiency was prevalent among Pakistani immigrants, and in great contrast to the vitamin D replete Norwegians. Serious vitamin D deficiency was interestingly not associated with reduced forearm bone density among Pakistani women. 相似文献
9.
M H Gannagé-Yared R Chemali N Yaacoub G Halaby 《Journal of bone and mineral research》2000,15(9):1856-1862
Hypovitaminosis D is associated with poor dietary intake and inadequate sunshine exposure. It is common worldwide, particularly in European elderly people. Information about vitamin D status in young adult populations from the Middle East is scarce. Furthermore, the relationship between hypovitaminosis D and some lifestyle factors such as style of clothing and dwelling location is not well defined. We assessed vitamin D intake and measured serum calcium, phosphorus, albumin, alkaline phosphatase, 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), osteocalcin, and urinary-free deoxypyridinoline (DPD) in 316 Lebanese volunteers (99 men and 217 women) aged 30-50 years; 156 were recruited from rural areas and 160 from urban areas. Fifty-one women from each area were veiled. The average daily vitamin D intake was 100.3 +/- 67.9 IU and was found to be higher in men compared with women, in urban subjects compared with rural ones and in nonveiled women compared with veiled ones. The mean level of 25(OH)D was 9.71 +/- 7.07 ng/ml. Hypovitaminosis D [25(OH)D < 12 ng/ml] affected 72.8% of our population. It was more common in women than in men (83.9% vs. 48.5%). Severe hypovitaminosis D [25(OH)D < 5 ng/ml] was observed in 30.7% of our subjects and was more prevalent in women (41.5%), particularly in the veiled ones (61.8%). 25(OH)D levels were the lowest in veiled women, and in women living in rural areas. Rural men had the highest 25(OH)D levels despite their very low vitamin D intake. In a multivariate model, inadequate vitamin D intake, urban dwelling, veil wearing, and high parity in women were independent predictors of hypovitaminosis D. 25(OH)D was related inversely to PTH and free DPD whereas osteocalcin achieved only a weak positive correlation with 25(OH)D. In the absence of information regarding time spent outdoors, our results show that hypovitaminosis D is common among young Lebanese people and is related mostly to low vitamin D intake. This should emphasize the need for more vitamin D in our population. 相似文献
10.
Julie M. Paik Gary C. Curhan John P. Forman Eric N. Taylor 《Calcified tissue international》2010,87(3):211-217
While the effects of calcium, phosphorus intake, and vitamin D on parathyroid hormone (PTH) have been well studied, less is
known about other factors that impact PTH. Our goal was to delineate associations between demographic, dietary, and plasma
factors and PTH. We conducted a cross-sectional study of intact PTH among 1,288 nonblack women in the Nurses Health Study
II aged 33–53 with BMI <30 kg/m2 and eGFR ≥60 ml/min/1.73 m2. Median PTH was 30.7 pg/ml. After adjusting for 25-hydroxyvitamin D and other factors, PTH was 4.1 pg/ml lower (95% CI −7.7
to −0.5) in women who smoked 1–14 cigarettes/day and 6.4 pg/ml lower (95% CI −11.2 to −1.7) in women who smoked >15 cigarettes/day
compared to nonsmokers. After multivariate adjustment, women whose BMI was 27–29 kg/m2 had PTH levels 2.0 pg/ml higher (95% CI 0.2–3.9) compared to BMI of 21–22 kg/m2 and women in the highest quartile of plasma phosphorus had PTH levels 4.1 pg/ml lower (95% CI −5.8 to −2.4) than women in
the lowest quartile. Higher vitamin A intake was independently associated with lower PTH, whereas lower calcium intake, lower
plasma calcium, lower plasma 25-hydroxyvitamin D, and winter blood draw were associated with higher PTH. Intakes of phosphorus,
animal protein, magnesium, alcohol, and caffeine were not associated with PTH. Factors not classically associated with calcium–phosphorus
metabolism impact PTH. Additional research is needed to elucidate the mechanisms whereby smoking, vitamin A, and phosphorus
affect PTH and to examine how body size and season may affect PTH independent of 25(OH)D. 相似文献
11.
M. Pfeifer B. Begerow H. W. Minne K. Suppan A. Fahrleitner-Pammer H. Dobnig 《Osteoporosis international》2009,20(2):315-322
Summary In 242 community-dwelling seniors, supplementation with either 1000 mg of calcium or 1000 mg of calcium plus vitamin D resulted
in a decrease in the number of subjects with first falls of 27% at month 12 and 39% at month 20. Additionally, parameters
of muscle function improved significantly.
Introduction The efficacy of vitamin D and calcium supplementation on risk of falling in the elderly is discussed controversially. Randomized
controlled trials using falls as primary outcome are needed. We investigated long-term effects of calcium and vitamin D on
falls and parameters of muscle function in community-dwelling elderly women and men.
Methods Our study population consisted of 242 individuals recruited by advertisements and mailing lists (mean [ ± SD] age, 77 ± 4 years).
All serum 25-hydroxyvitamin D (25[OH]D) levels were below 78 nmol/l. Individuals received in a double blinded fashion either
1000 mg of calcium or 1000 mg of calcium plus 800 IU of vitamin D per day over a treatment period of 12 months, which was
followed by a treatment-free but still blinded observation period of 8 months. Falls were documented using diaries. The study
took place in Bad Pyrmont, Germany (latitude 52°) and Graz, Austria (latitude 46°).
Results Compared to calcium mono, supplementation with calcium plus vitamin D resulted in a significant decrease in the number of
subjects with first falls of 27% at month 12 (RR = 0.73; CI = 0.54–0.96) and 39% at month 20 (RR = 0.61; CI = 0.34–0.76).
Concerning secondary endpoints, we observed significant improvements in quadriceps strength of 8%, a decrease in body sway
of 28%, and a decrease in time needed to perform the TUG test of 11%.
Discussion Combined calcium and vitamin D supplementation proved superior to calcium alone in reducing the number of falls and improving
muscle function in community-dwelling older individuals.
Parts of this work were presented as oral presentations at the 26th Annual Meeting of the American Society for Bone and Mineral
Research (ASBMR) in Seattle, Washington, October 2004 and at the IOF World Congress on Osteoporosis in Toronto, Canada, June
2006. 相似文献
12.
Background: Biliopancreatic diversion (BPD) is an efficient method for treating morbid obesity.We present the BPD technique
by laparoscopy and the 1st year follow-up. Methods: From July 2000 to April 2001, 40 patients underwent laparoscopic BPD (29
women, 11 men), with average age 39 (17-60). Average BMI was 43.6 kg/m2 (38-65). All operations were completed sucessfuly
by laparoscopy. The technique followed strictly the operation of Scopinaro. 7 of these patients had removal of an adjustable
gastric band and were converted to BPD. All underwent cholecystectomy. Results: Mean loss of initial excess weight at 3, 6
and 10 months was ≈ 30%, 50% and 90%. Mortality was 2.5% (1 patient) due to massive pulmonary embolism. Average operating
time was 210 minutes (130-480), and average hospital stay was 4.3 days (3-21). There were 5 postoperative complications (12.5%):
2 pulmonary emboli, 2 GI bleeding from the staple-line, and 1 fistula.There have been 5 late complications (12.5%): 3 cases
of diarrhea, 2 elevated PTH with normal calcium, and hypothyroidism that was dificult to control. Conclusion: BPD may be performed
by laparoscopy without changes in the original technique or in the early results. 相似文献
13.
R. M. Francis 《Calcified tissue international》1997,60(1):111-114
There is a decline in serum 25 hydroxyvitamin D (25OHD), 1,25 dihydroxyvitamin D (1,25(OH)2D), and calcium absorption with advancing age, which may lead to secondary hyperparathyroidism and bone loss. Studies show
a relationship between serum 25OHD and bone density in older men and women, with an inverse correlation between bone density
and parathyroid hormone (PTH). Vitamin D supplementation in this age group improves calcium absorption, suppresses PTH, and
decreases bone loss. Vitamin D many also reduce the incidence of hip and other nonvertebral fractures, particularly in the
frail elderly who are likely to have vitamin D deficiency. Patients with established vertebral osteoporosis have lower calcium
absorption than age-matched control subjects, possibly due to reduced serum 1,25(OH)2D or to relative resistance to the action of vitamin D on the bowel. Malabsorption of calcium in women with vertebral crush
fractures does not usually respond to treatment with physiological doses of vitamin D, but can be corrected by pharmacological
doses of vitamin D or by low doses of calcitriol or alfacalcidol. In a recent randomized, controlled study in 46 elderly women
with radiological evidence of vertebral osteoporosis, alfacalcidol 0.25 μg twice daily improved calcium absorption, decreased
serum PTH, and reduced alkaline phosphatase, whereas vitamin D2 500–1000 IU daily had no effect over the 6-month study period. Studies of the effect of the vitamin D metabolites in the
management of elderly women with established vertebral osteoporosis have yielded conflicting results, but suggest that alfacalcidol
and calcitriol may decrease spinal bone loss and reduce the incidence of vertebral fractures. Although vitamin D supplementation
decreases bone loss and fracture risk in the frail elderly, vitamin D metabolites may prove more useful in the treatment of
elderly women with vertebral osteoporosis. 相似文献
14.
Hypercalciuria of intestinal origin has been linked with bone loss in calcium nephrolithiasis and idiopathic osteoporosis.
This retrospective data analysis was performed to explore potential pathogenetic link between intestinal hyperabsorption of
calcium and postmenopausal osteoporosis. Data were retrieved from postmenopausal women who were evaluated for osteoporosis
or osteopenia at the Mineral Metabolism Clinic of UT Southwestern Medical Center. A total of 319 patients underwent the test
of calciuric response to oral calcium load to obtain an indirect measure of intestinal calcium absorption. Serum and urinary
biochemistry and L2–L4 bone mineral density (BMD) were compared between five quintiles of calciuric response. There was a
statistically significant trend toward a rise in 24-h urinary calcium and a decrease in urinary deoxypyridinoline (DPD) and
BMD, with increasing order of quintiles. The presentation of those in the 1st quintile was consistent with vitamin D insufficiency
or deficiency, with impaired calcium absorption, secondary hyperparathyroidism, and stimulated bone turnover (high normal
urinary DPD). In contrast, patients in the 5th quintile displayed a picture of absorptive hypercalciuria of stone disease,
with intestinal hyperabsorption of calcium, high or high normal urinary calcium and suppressed bone turnover (low or low normal
urinary DPD). Thus, the assessment of intestinal calcium absorption in a seemingly homogeneous group of postmenopausal women
with osteoporosis or osteopenia revealed a spectrum of calciuric response whose extremes may represent two physiologically
distinct subtypes that have important diagnostic and therapeutic implications. 相似文献
15.
J. A. Gracia M. Martínez M. Elia V. Aguilella P. Royo A. Jiménez M. A. Bielsa D. Arribas 《Obesity surgery》2009,19(4):432-438
Background Many techniques have excellent results at 2 years of follow-up but some matters regarding their long-term efficacy have arisen.
This is why bariatric surgery results must be analyzed in long-term follow-up. The aim of this study was to extend the analysis
over 5 years, evaluating weight loss, morbidity, and mortality of the surgical procedures performed.
Methods This was a retrospective cohort study of the different procedures for morbid obesity practiced in our Department of Surgery
for morbid obesity. The results have been analyzed in terms of weight loss, morbidity improvement, and postoperative morbidity
(Bariatric Analysis And Reporting Outcome System).
Results One hundred twenty-five patients were operated on open vertical banded gastroplasty (VBG), 150 patients of open biliopancreatic
diversion (BPD) of Scopinaro, 100 patients of open modified BPD (common limb 75 cm; alimentary limb 225 cm), and 115 patients
of laparoscopic Roux-en-Y gastric bypass (LRYGBP). Mean follow-up was: VBG 12 years, BPD 7 years, and LRYGBP 4 years. An excellent
initial weight loss was observed at the end of the second year of follow-up in all techniques, but from this time an important
regain of weight was observed in VBG group and a discrete weight regain in LRYGBP group. Only BPD groups kept excellent weight
results so far in time. Mortality was: VBG 1.6%, BPD 1.2%, and LRYGBP 0%. Early postoperative complications were: VBG 25%,
BPD 20.4%, and LRYGBP 20%. Late postoperative morbidity was: protein malnutrition 11% in Scopinaro BPD, 3% in Modified BPD
group, and no cases reported either in VBG group or LRYGBP group; iron deficiency 20% VBG, 62% Scopinaro BPD, 40% modified
BPD, and 30.5% LRYGBP. A 14.5% of VBG group required revision surgery to gastric bypass or to BPD due to 100% weight regain
or vomiting. A 3.2% of Scopinaro BPD with severe protein malnutrition required revision surgery to lengthen common limb to
100 cm. A 0.8% of LRYGBP required revision surgery to distal LRYGBP (common limb 75 cm) due to 100% weight regain.
Conclusions The most complex bariatric procedures increase the effectiveness but unfortunately they also increase morbidity and mortality.
LRYGBP is safe and effective for the treatment of morbid obesity. Modified BPD (75–225 cm) can be considered for the treatment
of superobesity (body mass index > 50 kg/m2), and restrictive procedures such as VBG should only be performed in well-selected patients due to high rates of failure
in long-term follow-up. 相似文献
16.
Longitudinal Evaluation of Vitamin D Status in Healthy Subjects from Southern Italy: Seasonal and Gender Differences 总被引:4,自引:0,他引:4
V. Carnevale S. Modoni M. Pileri A. Di Giorgio I. Chiodini S. Minisola R. Vieth A. Scillitani 《Osteoporosis international》2001,12(12):1026-1030
Vitamin D status is currently considered among the relevant determinants of skeletal integrity. Since vitamin D levels present
seasonal variations, we longitudinally studied young healthy men and women in order to investigate the related physiologic
modifications of both calcium homeostasis and bone remodeling. Thirty-two men (mean age 39.4 ± 7.8 years) and 58 premenopausal
women (aged 36.9 ± 6.4 years) from southern Italy were studied. In all subjects the following parameters were measured both
in winter and in summer: serum calcium, phosphorus, creatinine, total alkaline phosphatase activity, 25-hydroxyvitamin D (25OHD),
parathyroid hormone (PTH), osteocalcin (BGP), together with urinary calcium (Ca/Cr), total pyridinoline (Pyr/Cr) and deoxypyridinoline
(d-Pyr/Cr), corrected for creatinine excretion. In both sexes 25OHD levels were significantly higher in summer, while PTH
values were lower, than in winter. The prevalence of hypovitaminosis D, defined by concentrations of 25OHD lower than 30 nmol/l,
was 17.8% in winter and 2.2% in summer in the whole sample, while it was 27.8% and 3.4%, respectively, among female subjects.
Indeed male subjects did not display hypovitaminosis D, having throughout the year significantly higher calcium and 25OHD
levels together with lower PTH values, than the women. Moreover, alkaline phosphatase total activity was more elevated in
men both in winter and in summer. In women, during winter, bone remodeling markers levels were higher while urinary calcium
levels were lower than in summer. In the whole sample serum 25OHD correlated positively with serum calcium and inversely with
PTH. The seasonal percentage variations in PTH were inversely correlated with those of Ca/Cr. Our results show a relatively
high prevalence of subclinical vitamin D deficiency among young healthy women from southern Italy. Significant gender-specific
differences have been demonstrated in both calcium homeostasis and skeletal remodeling indexes; the seasonal fluctuations
in the vitamin D–PTH axis are accompanied by cyclical variations of bone turnover rate, which were more pronounced in women.
Received: 11 January 2001 / Accepted: 6 July 2001 相似文献
17.
M. J. Bolland A. B. Grey R. W. Ames B. H. Mason A. M. Horne G. D. Gamble I. R. Reid 《Osteoporosis international》2006,17(12):1742-1748
Introduction Previously we reported seasonal variation in 25-hydroxyvitamin D (25OHD) levels in postmenopausal women living in a subtropical climate. Because studies have suggested that there are gender differences in 25OHD levels, we sought to determine (1) the levels and determinants of 25OHD in men drawn from the same community, (2) whether seasonal variation of 25OHD occurs in men at this latitude (37°S), and (3) whether these findings were comparable to those we previously observed in postmenopausal women.Methods Cross-sectional study of 378 healthy, middle-aged and older community-dwelling men in Auckland, New Zealand.Results The mean 25OHD (SD) level was 85 (31) nmol/l. We found significant seasonal variation in 25OHD levels (peak in autumn 103 nmol/l, nadir in spring 59 nmol/l). Vitamin D insufficiency (25OHD <50nmol/l) was uncommon (prevalence in summer 0–17%, in winter 0–20%). The major determinants of 25OHD were month of blood sampling, fat percentage, physical activity, and serum albumin. Men had higher levels of 25OHD throughout the year than women did, a finding that persisted after adjusting for potential confounding factors. In men and women the determinants of 25OHD were similar.Conclusion There is significant seasonal variation in 25OHD levels in men living in a subtropical climate. In contrast to postmenopausal women, men have low rates of suboptimal vitamin D status, even in winter. Routine vitamin D supplementation for this population of men is not warranted. 相似文献
18.
Jameela Abdulaziz Kari Osama T. Baghdadi Sherif El-Desoky 《Pediatric nephrology (Berlin, Germany)》2013,28(6):933-937
Background
We aimed to investigate the effect of single, high-dose intramuscular cholecalciferol on vitamin D3 and intact parathyroid hormone (iPTH) levels in children with chronic kidney disease (CKD).Methods
Between January 2012 and June 2012, we conducted a prospective, uncontrolled study at the Pediatric Nephrology Unit of King Abdulaziz University Hospital, Jeddah, to investigate the effect of single, high-dose intramuscular vitamin D3 on 25(OH)D3 and iPTH levels in vitamin D insufficient/deficient children with CKD. Serum vitamin D3, iPTH, calcium, phosphate, alkaline phosphatase (ALP), and creatinine levels were measured before intramuscular vitamin D3 (300,000 IU) administration, and these were subsequently repeated at 1 and 3 months after treatment. Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA).Results
Nineteen children fulfilled the criteria. At 3 months after treatment, vitamin D3 levels were significantly higher than at baseline (p?<?0.001) but lower than the levels at 1 month. iPTH levels decreased significantly at 3 months (p?=?0.01); however, the drop in iPTH levels was not significant at 1 month (p?=?0.447). There were no changes in calcium, phosphate, ALP, or creatinine levels after treatment.Conclusions
Single-dose intramuscular vitamin D3 (300,000 IU) resulted in significant improvement of vitamin D3 and iPTH levels in children with CKD. 相似文献19.
Srivastava AK Libanati C Hohmann O Kriegman A Baylink DJ 《Calcified tissue international》2004,75(6):477-481
Salmon calcitonin is a potent inhibitor of osteoclastic activity. The effect of calcitonin in elderly women with high bone turnover at higher risk of developing osteoporosis has not been studied. To investigate acute effects of calcitonin treatment on bone resorption markers in elderly women, we conducted a randomized trial in women >65 years of age with high bone turnover assessed as urinary N-telopeptide of type-I collagen (NTx) levels 1 SD higher than mean premenopausal levels, which was irrespective of bone density. A total of 98 elderly women were randomly assigned to receive either 200 IU calcitonin nasal spray (n = 75) with calcium (500 mg) and vitamin D (200 IU) or calcium and vitamin D (n = 23) alone for 6 months. Blood and urine samples were collected at 0, 2, 4, and 6 months and analyzed for urinary NTx and serum C-telopeptide of type-1 collagen (CTx). At baseline, mean age was 72.1 ± 4.7 (mean ± SD) in the calcitonin group and 72.2 ± 6 years in the control group. The spine and total hip BMD, serum PTH levels and urinary calcium/creatinine ratios were similar in both groups. Mean BMD was in the osteopenic range in both groups. Calcitonin treatment resulted in significant decreases in serum CTx levels, 2, 4 and 6 months after treatment as compared to baseline, and after 4 and 6 months as compared to controls. A maximum decrease from baseline of 33% was seen at 6 months. The urinary resorption marker, urine NTx, showed a significant decrease in the calcitonin group when compared to baseline only at the 6-month time point. Analysis of least significance change (LSC) showed that 70% of calcitonin patients were categorized as responders using serum CTx after 6 months of treatment. We conclude that 200 IU calcitonin effectively decreases bone resorption within 60 days of therapy, thus preventing further bone loss in elderly women who are at a high risk of developing osteoporosis. 相似文献
20.
J. Guillemant P. Taupin H. T. Le N. Taright A. Allemandou G. Pérès S. Guillemant 《Osteoporosis international》1999,10(3):222-225
The vitamin D status was determined on one to four occasions either after summer (September–October) or after winter (March–April)
in 175 male adolescents (13–17 years), resulting in 394 measurements of serum 25-hydroxyvitamin D (25(OH)D) and intact parathyroid
hormone (iPTH). The subjects lived in a rural area to the north of Paris (49° N). After summer the 25(OH)D concentration was
58.5 ± 18.0 nmol/l (mean ± SD), while after winter it had fallen to 20.6 ±6.0 nmol/l (p= 0.0001). Meanwhile the iPTH concentration was 2.76 ± 0.97 pmol/l (mean ± SD) after summer and increased to 4.20 ± 1.21
pmol/l after winter (p= 0.0001). All the results were pooled and a nonlinear population model with random parameters was used to describe the relationship
between serum iPTH and 25(OH)D. When the concentration of 25(OH)D was higher than 83 nmol/l, an iPTH mean ‘plateau’ level
at 2.48 pmol/l was reached. When 25(OH)D concentrations fell below 83 nmol/l, the increase in iPTH concentration accelerates,
and when the mean 25(OH)D concentration was equal to or lower than 10 nmol/l the mean iPTH level (4.97 pmol/l) was twice as
high as the ‘plateau’ value.
Received: 26 November 1998 / Accepted: 15 February 1999 相似文献