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TERESA E. FRAZER, NEIL H. WHITE, STEPHEN HOUGH, JULIO V. SANTIAGO, BONNIE R. McGEE, GRAHM BRYCE, JOHN MALLON, LOUIS V. AVIOLI, Alterations in Circulating Vitamin D Metabolites in the Young Insulin-Dependent Diabetic, The Journal of Clinical Endocrinology & Metabolism, Volume 53, Issue 6, 1 December 1981, Pages 1154–1159, https://doi.org/10.1210/jcem-53-6-1154
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Abstract
To assess the relationship between the decreased bone mass observed in young insulin-requiring diabetic patients and vitamin D metabolism, we measured serum 25-hydroxyvitamin D, 24,25-dihydroxyvitamin D, and 1,25-dihydroxyvitamin D concentration in 45 white, insulin-dependent diabetic subjects, 7-18 yr of age. Metacarpal cortical thickness in 87% of these diabetics was below the mean for their respective ages, while 16% had a cortical thickness value greater than 2 SDS below the mean. Serum calcium and phosphate concentrations were normal, immunoreactive parathyroid hormone was in the low normal range, and total serum alkaline phosphatase was elevated compared to age- and sex-matched controls. Circulating 24,25-dihydroxyvitamin D concentrations were significantly elevated, and 1,25-dihydroxyvitamin D was significantly decreased. The increase in 24,25-dihydroxyvitamin D was greater in the diabetics with the most severe bone loss and was maximally increased during the first 5 yr of clinical diabetes. No apparent correlation was seen between metabolic control, as measured by hemoglobin A1C and urine and plasma glucose, and the circulating levels of the vitamin D metabolites.
Despite appropriate insulin replacement, alterations in vitamin D metabolism occur in the young insulin-dependent diabetic and could relate to the decrease in cortical bone mass observed in these patients.