Poster Session : PS 0157 ; Diabetes : Diabetes Mellitus : A Synonym to Functional Hypoparathyroidism

저작시기 2014.01 |등록일 2015.01.05 | 최종수정일 2015.04.23 파일확장자어도비 PDF (pdf) | 1페이지 | 가격 1,000원
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발행기관 : 대한내과학회 수록지정보 : 대한내과학회 추계학술발표논문집 / 2014권 / 1호
저자명 : ( Amit Saraf )

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Background: Poor blood glucose control in diabetes mellitus has been attributed with reduced bone mass, but the pathogenetic mechanisms still largely remains unknown. It has been hypothesized that poor blood glucose control results in a form of renal hypercalciuria which by parathyroid stimulation, might in part contribute to osteopenia. In view of this, the present study undertakes to investigate, simultaneously, parameters of calcium metabolism in relation to diabetic control Methods: 250 patients with diabetes and normal renal function ( 70 Type 1 and 180 Type 2) were studied. In all patients plasma calcium (Ca), serum phosphate (PO4), serum parathyroid hormone (PTH), and 24-h urinary calcium (uCa) were determined under both poor and improved control (for at least 7 days) as ascertained by four blood glucose determinations daily. Results: Improvement of blood glucose control (p = 0.001) was associated with reduction of uCa both in Type 1 (6.5 ± 1 vs 4.5 ± 0.8 mmol per day, mean ± SEM, p = 0.02) and in Type 2 patients (4.0 ± 0.5 vs 3.0 ± 0.4 mmol per day, mean ± SEM, p = 0.002). Type 1 patients (33 out of 70) had PTH values below the detection limit (1.5 pmol per l) during poor than during improved control (10 out of 70). Under poor control of blood sugar levels, Ca and PTH were lower (p = 0.03), while uCa was higher (p = 0.003), and after improved control, only uCa continued to be higher (p = 0.035). Conclusions: These fi ndings suggest that increased uCa excretion in association witih ‘functional hypoparathyroidism’ (especially in Type 1 diabetes) is observed during poor blood glucose control, and may be one of the factors leading to reduced bone mass in diabetes mellitus.

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      Poster Session : PS 0157 ; Diabetes : Diabetes Mellitus : A Synonym to Functional Hypoparathyroidism
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