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Alteration in osteoblast activity and nutritional vitamin-D deficiency in non-hypercalcemic malignancy

  • Clinical Investigations
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Summary

The biochemical parameters of bone mineral metabolism in patients with nonhypercalcemic malignancy have not been extensively investigated. Therefore, a group of 29 such patients with different types of malignancy was studied. Ten patients received corticosteroids. In the entire group, serum ionized calcium (Ca2+), bone gla protein (BGP), 25-hydroxyvitamin D (25OHD), and 1,25-dihydroxyvitamin D (1,25(OH)2D) were all lower than in age-matched controls, and carboxy-terminal parathyroid hormone (CPTH) was higher. Although both corticosteroid- and noncorticosteroid-treated patients had decreased BGP values, the corticosteroid-treated patients had lower BGP levels than those not on steroids (4.24±0.70 SE vs. 11.50±2.20 ng/ml;P<0.005). Patients on corticosteroids had lower 1,25(OH)2D values than controls (18.81 ±2.71 vs. 27.83±1.17 pg/ml;P<0.01), whereas those not on corticosteroids had normal 1,25(OH)2D values. These results suggest that patients with nonhydpercalcemic malignancy have nutritional vitamin-D deficiency and secondary hyperparathyroidism with perhaps corticosteroid-induced suppression of serum 1,25(OH)2D and BGP. The decreased levels of serum BGP in the nonsteroid-treated patients suggest, in addition, a defect in osteoblast function.

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Authors and Affiliations

  1. Division of Endocrinology/Metabolism, Albert Einstein Medical Center, York and Tabor Roads, 19141, Philadelphia, Pennsylvania

    Paul S. Jowell, Sol Epstein M.D. & Firhaad Ismail

  2. Division of Hematology/Oncology, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA

    I. Robert Schwartz

  3. Temple University, Philadelphia, Pennsylvania, USA

    Bruce Hollis

  4. Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA

    Bruce Hollis

Authors
  1. Paul S. Jowell
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  2. Sol Epstein M.D.
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  3. Firhaad Ismail
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  4. Bruce Hollis
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  5. I. Robert Schwartz
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Jowell, P.S., Epstein, S., Ismail, F. et al. Alteration in osteoblast activity and nutritional vitamin-D deficiency in non-hypercalcemic malignancy. Calcif Tissue Int 42, 18–22 (1988). https://doi.org/10.1007/BF02555834

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  • DOI: https://doi.org/10.1007/BF02555834

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