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Plasma 25-hydroxyvitamin D and urinary cyclic AMP in German patients with subtotal gastrectomy (Billroth II)

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Abstract

In an attempt to clarify the pathogenesis of the disturbed calcium metabolism which sometimes follows partial gastrectomy, we determined plasma 25-hydroxyvitamin D (25-OH-D) concentrations and urinary cyclic 3′, 5′-adenosine monophosphate (cAMP) excretion in patients who had previously undergone Billroth II gastrectomy and who were without clinical evidence of bone disease. In 17 Billroth II patients plasma 25-OH-D concentrations were reduced (12.6±4.6 ng/ml, mean ±sd) compared to values in 17 control patients with diseases not affecting calcium metabolism (31.6±12.9 ng/ml,P<0.001). Urinary cAMP excretion, in part reflecting parathyroid function, was higher in 17 Billroth II patients (5.0±2.5 μmol/day) than in the control patients (2.6±1.3 μmol/day,P<0.001). These results suggest impaired nutrition of vitamin D and secondary hyperparathyroidism in Billroth II patients. While the cause of this phenomenon is unclear, it may contribute to the disturbance of calcium metabolism in patients who have had subtotal gastrectomy.

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References

  1. Thompson GR, Lewis B, Booth CC: Vitamin D absorption after partial gastrectomy. Lancet 1:2215–2218, 1971

    Google Scholar 

  2. Jones CT, Williams JA, Cox EV, Maynell MJ, Coose WT, Stammers FAR: Peptic ulceration: Some haematological and metabolic consequences of gastric surgery. Lancet 2:425–427, 1962

    Google Scholar 

  3. Deller DJ, Edwards RG, Addison M: Calcium metabolism and the bones after partial gastrectomy. II. The native and cause of the bone disorder. Aust Ann Med 12:295–309, 1963

    Google Scholar 

  4. Hall GH, Neal G: Bone rarefication after partial gastrectomy. Ann Intern Med 59:455–463, 1963

    Google Scholar 

  5. Chalmers J: Osteomalacia. J R Coll Surg Edinb 13:255–275, 1968

    Google Scholar 

  6. Garrick R, Ireland AW, Posen S: Bone abnormalities after gastric surgery. Ann Intern Med 75:221–225, 1971

    Google Scholar 

  7. Morgan DB, Paterson, CR, Woods CG, Pulvertaft CM, Fourman P: Search for osteomalacia in 1228 patients after gastrectomy and other operations on the stomach. Lancet 2:1085–1088, 1965

    Google Scholar 

  8. Arnaud SB, Arnaud CD, Bordier PJ, Goldsmith RS, Flueck JA: The interrelationships between vitamin D and parathyroid hormone in disorders of mineral metabolism in man. Vitamin D and Problems Related to Uremic Bone Disease. AW Norman, K Schaefer, HG Grigoleit, D von Herrath, E Ritz (eds): Berlin, Walter de Gruyter, 1975, pp 397–416

    Google Scholar 

  9. Bayard R, Bec Ph, Louvet JP: Measurement of plasma 25-hydroxycholecalciferol in man. Eur J Clin Invest 2:195–198, 1972

    Google Scholar 

  10. Taylor AL, Davis BB, Pawlson LG, Josimowitsch JB, Mintz DM: Factors influencing the urinary excretion of 3′, 5′-monophosphate in humans. J Clin Endocrinol Metab 30:316–324, 1970

    Google Scholar 

  11. McLaughlin M, Raggatt PR, Fairney A, Brown DJ, Lester E, Wills MR: Seasonal variations in serum 25-hydroxycholecalciferol in healthy people. Lancet 1:536–538, 1974

    Google Scholar 

  12. Haddad J, Chyu KR: Competitive protein-binding radioassay for 25-hydroxycholecalciferol. J Clin Endocrinol 33:992–995, 1971

    Google Scholar 

  13. Lilienfeld-Toal H v, Becker WM: 25-Hydroxycholecalciferol resorption test. Vitamin D and Problems Related to Uremic Bone Disease. AW Norman, K Schaefer, HG Grigoleit, D von Herrath, E Ritz (eds): Berlin, Walter de Gruyter, 1975, pp 355–361

    Google Scholar 

  14. Brown BL, Ekins RP, Tampion W: The assay of adenosine 3′, 5′-cyclic monophosphate by saturation analysis. Biochem J 120:8, 1970

    Google Scholar 

  15. Lilienfeld-Toal, Hv, Hesch RD, Huefner M, McIntosh C: Excretion of 3′, 5′-adenosine monophosphate in renal insufficiency and hyperparathyroidism after stimulation with parathryoid hormone. Horm Metab Res 6:315–318, 1974

    Google Scholar 

  16. Gomori G: A modification of the colorimetric phosphorus determination for use with the photoelectric colorimeter. J Lab Clin Med 27:955–960, 1942

    Google Scholar 

  17. Hausamen TU, Helger R, Rick W, Gross W: Optimal conditions for the determination of serum alkaline phosphatase. Clin Chim Acta 15:241–245, 1967

    Google Scholar 

  18. Thefeld W, Hoffmeister H, Busch EW, Koller PU, Vollmar J: Referenzwerte fuer die Bestimmungen der Transaminasen GOT und GPT sowie der alkalischen Phosphatase im Serum mit optimierten Standardmethoden. Dtsch Med Wochenschr 99:343–351, 1974

    Google Scholar 

  19. Chasson AL, Grady HJ, Stanley MA: Determination of creatinine by means of automatic chemical analysis. Am J Clin Pothol 35:83–88, 1961

    Google Scholar 

  20. Stamp TCD: Intestinal absorption of 25-hydroxycholecalciferol. Lancet 2:121–123, 1974

    Google Scholar 

  21. Hillman H: Postgastrectomy malnutrition. Gut 9:576–584, 1968

    Google Scholar 

  22. Arnaud SB, Goldsmith RS, Lambert PW, Go VLW: 25-Hydroxyvitamin D3: Evidence of an enterohepatic circulation in man. Proc Soc Exp Biol Med 149:570–572, 1975

    Google Scholar 

  23. Kuhlencordt F, Bartelheimer H: Die Auswirkungen der Magenresektion auf des Skelett. Gastroenterologia (Suppl) 107:14–18, 1967

    Google Scholar 

  24. Arztrecht in der Praxis: Dr. Schiedermaier: Gesundheitliche Aspekte des neuen Lebensmittelgesetzes. Dtsch Med Wochenschr 100:1305–1308, 1975

    Google Scholar 

  25. Harvald B, Krogsgaard AR, Lous P: Calcium deficiency following partial gastrectomy. Acta Med Scand 172:497–503, 1962

    Google Scholar 

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Lilienfeld-Toal, H.v., Mackes, K.G., Kodrat, G. et al. Plasma 25-hydroxyvitamin D and urinary cyclic AMP in German patients with subtotal gastrectomy (Billroth II). Digest Dis Sci 22, 633–636 (1977). https://doi.org/10.1007/BF01073083

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