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Bone Abstracts (2015) 4 P194 | DOI: 10.1530/boneabs.4.P194

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Results of conservative treatment in patients with phosphate diabetes

Stepan Martsyniak1, Iurii Guk1, Tamara Kinchaya-Polishchuk1, Andrii Zyma1, David G Stewart2, Gennadii Bondariev1 & Olha Pankina1

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1Institute of Orthopedics and Traumatology, National Academy of Medical Sciences, Kyiv, Ukraine; 2Childrens Bone and Spine Surgery, Las-Vegas, Nevada, USA.


Objective: Bone metabolism was studied in patients with phosphate diabetes before and after medication.

Methods: 39 patients with phosphate diabetes age 2–18 years (7.8±4 years, 64% male) and multiplanar deformities of the lower extremities were treated with monthly vitamin D (2000 IU/day), alfacalcidol (0.25 mg/every other day) and calcium glycerophosphate (600 mg/day) for 6 months.

Biochemical indices were evaluated before (n=39) and after treatment (n=5), Table 1.

Results: After treatment, 25-hydroxy vitamin D increased 2.12 times (P<0.05), 1,25-dihydroxy vitamin D increased 1.8 times (P<0.05), and osteocalcin decreased in two times (P<0.05).

Strong correlations were observed only between 25-hydroxy vitamin D and 1,25-dihydroxy vitamin D (Table 2).

After treatment, positive correlations were seen between Ca and Ca+, Ca+ and 1,25-dihydroxy vitamin D, 25-hydroxy vitamin D and osteocalcin, 25-hydroxy vitamin D and B-CTx, 1,25 dihydroxy vitamin D and P1NP, urinary calcium and urinary phosphate, B-CTx and osteocalcin. Negative correlations were observed between PTH and 1,25-dihydroxy vitamin D, PTH and B-CTx, urinary phosphate and osteocalcin, B-CTx and urinary phosphate. (Table 3)

Table 1
Indicators of bone metabolism/stages of treatmentBefore treatmentAfter treatment
Ionized calcium1.21±0.011.25±0.02
Serum phosphate0.62±0.030.67±0.07
Calcium2.34±0.022.44±0.03
25(OH)2D19.30±2.0140.97*±7.07
1,25(OH)2D74.15±3.89134.60*±13.39
PTH48.66±4.5939.01±12.86
Osteocalcin123.35±10.2759.11*±34.05
Urinary calcium (daily)2.42±0.252.54±0.94
Urinary phosphate (daily)34.09±1.3626.52±3.15
P1NP815.03±59.86576.4±205.65
B-CTx2.16±0.111.69±0.46
*Significant difference treatment P<0.05. Trend close to significant, 0.1> P>0.05.
Table 2
Ca+PCa25(OH)2D1,25(OH)2DPTHOsteocalcinUrine calcium (daily)Urine phosphor (daily)P1NPB-CTx
Ca+1.000.160.240.040.030.060.060.27−0.020.350.02
P0.161.000.250.270.240.070.19−0.04−0.630.040.04
Ca0.240.251.000.230.52−0.38−0.13−0.18−0.420.24−0.09
25(OH)2D0.040.270.231.000.80−0.34−0.01−0.30−0.130.060.23
1,25(OH)2D0.030.240.520.801.00−0.39−0.38−0.31−0.34−0.040.05
PTH0.060.07−0.38−0.34−0.391.00−0.320.490.37−0.36−0.62
osteocalcin0.060.19−0.13−0.01−0.38−0.321.00−0.02−0.190.520.60
urine calcium (daily)0.27−0.04−0.18−0.30−0.310.49−0.021.000.410.27−0.01
urine phosphor (daily)−0.02−0.63−0.42−0.13−0.340.37−0.190.411.00−0.13−0.18
P1NP0.350.040.240.06−0.04−0.360.520.27−0.131.000.74
B-CTx0.020.04−0.090.230.05−0.620.60−0.01−0.180.741.00
Correlations (marc vdrr.sta). Marked correlations are significant at P<0.05000. n=39 (Casewise deletion of missing data).
Table 3
Ca+PCa25(OH)2D1,25(OH)2DPTHOsteocalcinUrine calcium (daily)Urine phosphor (daily)P1NPB-CTx
Ca+1.000.110.85−0.350.86−0.500.280.610.060.480.03
P0.111.00−0.37−0.60−0.120.690.280.700.590.18−0.53
Ca0.85−0.371.00−0.160.75−0.70−0.230.18−0.250.240.16
25(OH)2D−0.35−0.60−0.161.000.16−0.570.90−0.66−0.680.400.92
1,25(OH)2D0.86−0.120.750.161.00−0.790.180.38−0.210.750.52
PTH−0.500.69−0.70−0.57−0.791.00−0.410.200.56−0.50−0.78
Osteocalcin−0.28−0.28−0.230.900.18−0.411.00−0.56−0.750.640.89
Urine calcium (daily)0.610.700.18−0.660.380.20−0.561.000.770.18−0.46
Urine phosphor (daily)0.060.59−0.25−0.68−0.210.56−0.750.771.00−0.41−0.75
P1NP0.480.180.240.400.75−0.500.640.18−0.411.000.68
B-CTx0.03−0.530.160.920.52−0.780.89−0.46−0.750.681.00
Correlations (marc vdrr.sta). Marked correlations are significant at P<0.05000. n=5 (Casewise deletion of missing data).

Conclusions: The medication protocol improves bone metabolism with phosphate diabetes, reduces osteomalacia, and improves ratios of bone formation and bone resorption.

Disclosure: The authors declared no competing interests.

Volume 4

7th International Conference on Children's Bone Health

Salzburg, Austria
27 Jun 2015 - 30 Jun 2015

ICCBH 

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