Skip to main content
NCBI home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1987 May;62(5):474–477. doi: 10.1136/adc.62.5.474

Serum 1,25 dihydroxyvitamin D and osteocalcin concentrations in thalassaemia major.

P Dandona, R K Menon, S Houlder, M Thomas, A V Hoffbrand, D M Flynn
PMCID: PMC1778375  PMID: 3496858

Abstract

In view of the claim that low 25-hydroxyvitamin D (25-OHD) concentrations may contribute to the pathogenesis of bone disease in patients with beta thalassaemia major and iron overload, we have assessed the concentrations of 25-OHD, 1 alpha,25 dihydroxyvitamin D (1 alpha,25(OH)2D), parathyroid hormone, and osteocalcin in such patients. 25-OHD concentrations were significantly lower in patients with thalassaemia major and iron overload than in controls and in some patients were subnormal or undetectable. 1 alpha,25(OH)2D concentrations were, however, normal in all patients and were similar to those in controls. Serum parathyroid hormone and plasma calcium concentrations were also normal and not significantly different from those in controls. Although 25-OHD concentrations increased significantly between January and June, there was no change in 1 alpha,25(OH)2D concentrations. 25-OHD concentrations remained lower than control values, even in June. Parathyroid hormone concentrations fell, but not significantly, between January and June, but calcium concentrations did not alter. Osteocalcin concentrations were normal in all patients except one, who had extremely low concentrations of this protein. The concentration of osteocalcin was not related to 25-OHD or 1 alpha,25(OH)2D concentrations. Thus normal calcium homeostasis is maintained in patients with thalassaemia major despite low or low-normal 25-OHD concentrations; this is probably achieved through the maintenance of normal 1 alpha,25(OH)2D concentrations, which were indistinguishable from those in controls. Normal 1 alpha,25(OH)2D, parathyroid hormone, and osteocalcin concentrations argue against an important role for vitamin D deficiency in the pathogenesis of thalassemia bone disease.

Full text

PDF
474

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aloia J. F., Ostuni J. A., Yeh J. K., Zaino E. C. Combined vitamin D parathyroid defect in thalassemia major. Arch Intern Med. 1982 Apr;142(4):831–832. [PubMed] [Google Scholar]
  2. Dandona P., Menon R. K., Shenoy R., Houlder S., Thomas M., Mallinson W. J. Low 1,25-dihydroxyvitamin D, secondary hyperparathyroidism, and normal osteocalcin in elderly subjects. J Clin Endocrinol Metab. 1986 Aug;63(2):459–462. doi: 10.1210/jcem-63-2-459. [DOI] [PubMed] [Google Scholar]
  3. Dandona P., Mohiuddin J., Weerakoon J. W., Freedman D. B., Fonseca V., Healey T. Persistence of parathyroid hypersecretion after vitamin D treatment in Asian vegetarians. J Clin Endocrinol Metab. 1984 Sep;59(3):535–537. doi: 10.1210/jcem-59-3-535. [DOI] [PubMed] [Google Scholar]
  4. Dines D. M., Canale V. C., Arnold W. D. Fractures in thalassemia. J Bone Joint Surg Am. 1976 Jul;58(5):662–666. [PubMed] [Google Scholar]
  5. Menon R. K., Gill D. S., Thomas M., Kernoff P. B., Dandona P. Impaired carboxylation of osteocalcin in warfarin-treated patients. J Clin Endocrinol Metab. 1987 Jan;64(1):59–61. doi: 10.1210/jcem-64-1-59. [DOI] [PubMed] [Google Scholar]
  6. Preece M. A., O'Riordan J. L., Lawson D. E., Kodicek E. A competitive protein-binding assay for 25-hydroxycholecalciferol and 25-hydroxyergocalciferol in serum. Clin Chim Acta. 1974 Jul 31;54(2):235–242. doi: 10.1016/0009-8981(74)90241-1. [DOI] [PubMed] [Google Scholar]
  7. Price P. A., Parthemore J. G., Deftos L. J. New biochemical marker for bone metabolism. Measurement by radioimmunoassay of bone GLA protein in the plasma of normal subjects and patients with bone disease. J Clin Invest. 1980 Nov;66(5):878–883. doi: 10.1172/JCI109954. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Rigotti N. A., Nussbaum S. R., Herzog D. B., Neer R. M. Osteoporosis in women with anorexia nervosa. N Engl J Med. 1984 Dec 20;311(25):1601–1606. doi: 10.1056/NEJM198412203112503. [DOI] [PubMed] [Google Scholar]
  9. Tsitoura S., Amarilio N., Lapatsanis P., Pantelakis S., Doxiadis S. Serum 25-hydroxyvitamin D levels in thalassaemia. Arch Dis Child. 1978 Apr;53(4):347–348. doi: 10.1136/adc.53.4.347. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Warren M. P., Brooks-Gunn J., Hamilton L. H., Warren L. F., Hamilton W. G. Scoliosis and fractures in young ballet dancers. Relation to delayed menarche and secondary amenorrhea. N Engl J Med. 1986 May 22;314(21):1348–1353. doi: 10.1056/NEJM198605223142104. [DOI] [PubMed] [Google Scholar]
  11. de Vernejoul M. C., Girot R., Gueris J., Cancela L., Bang S., Bielakoff J., Mautalen C., Goldberg D., Miravet L. Calcium phosphate metabolism and bone disease in patients with homozygous thalassemia. J Clin Endocrinol Metab. 1982 Feb;54(2):276–281. doi: 10.1210/jcem-54-2-276. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES