The role of vitamin D and parathyroid hormone in the osteoporosis in spinal cord injury
Background. Osteoporosis and vitamin D deficiency are known complications of spinal cord injury (SCI). The role of vitamin D and parathyroid hormone (PTH) in the SCIinduced osteoporosis remain controversial. The purpose of the study was to determine the vitamin D and PTH levels and its relationship with bone loss in SCI persons. Materials and methods. Sixtynine SCI persons and 43 people of the corresponding age and gender in the comparison group were examined. The levels of vitamin D, PTH as well as bone resorption marker (βCTx) were determined using the electrochemiluminescent method. Bone loss was examined by dualenergy Xray absorptiometry and ultrasound (US) densitometry of the calcaneus. Results. The vitamin D level in SCI persons was significantly lower than in the comparison group (12.7 ± 8.9 versus 24.6 ± 9.8 ng/ml; t = 6.6; p < 0.0001). The PTH, calcium and phosphorus levels did not differ. The vitamin D level decreased significantly and PTH increased significantly with the increase of SCI duration. The PTH also increased significantly with a decrease in the vitamin D level. There was no correlation between the level of vitamin D and the bone parameters. However, a positive correlation was found between the PTH level and the calcaneus Zindex in chronic SCI (over 5 years), as well as a significant negative correlation between the bone resorption markers (βCTx) and PTH. Conclusions. Low PTH level, rather than elevated level indicates increased bone resorption and can be considered as a risk factor for SCIinduced osteoporosis.
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