Calorie restriction increases serum parathyroid hormone and decreases serum calcitonin levels in patients with maturity onset diabetes mellitus |
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Authors: | Kiyoshi Hashizume Kazuo Ichikawa Satoru Suzuki Teiji Takeda Keishi Yamauchi Mutsuhiro Kobayashi Xiao-Yun MA |
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Institution: | (1) Department of Geriatrics, Endocrinology and Metabolism, Shinshu University School of Medicine, 390 Matsumoto, Japan |
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Abstract: | Calorie restriction is important in managing patients with maturity onset diabetes mellitus (NIDDM). The effect of such restriction
on calcium metabolism is not known. The objective of this study was to determine whether patients on calorie restricted diets
would show any modification of parathyroid hormone (PTH) and calcitonin (CTN).
The serum levels of PTH and CTN were measured by radioimmunoassays in 269 patients with NIDDM. The patients were divided into
two groups depending on the intake of calorie, and PTH and CTN were monitored for 2 years. Plasma levels of vitamin D were
measured by competitive protein binding assays before and after each program.
The level of PTH (520.8±266.0 pg/ml) (mean±S.D.) was significantly (P<0.01) higher in 109 diabetic patients whose calorie intake was restricted for 2 years (diet (D) group) as compared with that
(256.6±103.8 pg/ml) of 160 diabetic patients whose calorie intake was not restricted (non-diet (ND) group). The daily oral
calcium intake of the two groups did not differ significantly. We found no significant difference in the serum PTH level in
the ND groupVS. normal control subjects (248.8±98.4, N=78). The serum calcium concentration and the amount of calcium excreted in urine
were slightly but significantly (P<0.01) lower in the D than in the ND group. The rate of tubular reabsorption of phosphate (% TRP) was significantly lower
in the D group than that in the ND group (P<0.01). The serum CTN level was significantly (P<0.01) lower in the D group (33.9±11.3 pg/ml) than in the ND group (64.9±21.2 pg/ml) 2 years after each treatment. The plasma
1,25-(OH)2-vitamin D level was significantly (P<0.01) lower in the D group (22.2±6.6 pg/ml) than in the ND group (50.6±4.2 pg/ml). When
the restriction of calorie intake in the D group was canceled, their PTH levels decreased, which was accompanied by increase
in the 1,25-(OH)2-vitamin D levels, whereas their CTN levels were unchanged.
These observations suggested that a restricted calorie intake is a risk factor for secondary hyperparathyroidism as well as
for a low serum level of CTN in patients with NIDDM. |
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Keywords: | Maturity-onset diabetes mellitus (NIDDM) Parathyroid hormone (PTH) Calcitonin (CTN) Vitamin D Calorie restriction |
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