| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Department of Neurology (Dr. Sato), Futase Social Insurance Hospital, Iizuka; the Diagnostic Equipment Department (Dr. Kikuyama), Teijin Limited, Tokyo; and the First Department of Internal Medicine(Dr. Oizumi), Kurume University School of Medicine, Kurume, Japan.
Address correspondence and reprint requests to Dr. Yoshihiro Sato, Department of Neurology, Kurume University Medical Center, 155-1 Kokubumachi, Kurume 839, Japan.
Despite excessive hip fractures in patients with Parkinson's disease (PD), little is known about bone changes in these patients. We measured bone mineral density (BMD; Z scores) in PD patients and analyzed its relation to serum biochemical indices and sunlight exposure. We measured BMD in 71 patients in the second metacarpals and divided the patients into two groups according to functional independence: group 1, Hoehn and Yahr stages 1 and 2; and group 2, stages 3 to 5. In four of 20 patients in group 1 (20%), the Z scores was less than -1.0, indicating osteopenia. In 51 patients in group 2, 31 (61%) had a Z score less than -1.0. The group 1 patients showed a normal mean serum level of 25-hydroxyvitamin D (25-OHD; 21.7 ng/ml), while most group 2 patients were in a deficiency range (group mean 8.9 ng/ml). Many group 2 patients were sunlight deprived. Both groups had elevated serum ionized calcium levels correlating positively with Hoehn and Yahr stage and markedly depressed serum 1,25-dihydroxyvitamin D(1,25-[OH]2D) concentrations, indicating that immobilization-induced hypercalcemia had inhibited 1,25-[OH]2D production. Z scores correlated positively with 25-OHD levels and negatively with parathyroid hormone concentration and Hoehn and Yahr stage. Vitamin D deficiency due to sunlight deprivation and hypercalcemia induces compensatory hyperparathyroidism, which contributes to reduced BMD in PD patients, particularly those who are functionally dependent. Low BMD increases risk of hip fractures in patients with PD but may be improved by vitamin D supplementation.
Received February 20, 1997. Accepted in final form May 29, 1997.
This article has been cited by other articles:
|
|
 |
|
  L. M. Zuckerman Parkinson's Disease and the Orthopaedic Patient J. Am. Acad. Ortho. Surg., January 1, 2009; 17(1): 48 - 55. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. L. Evatt, M. R. DeLong, N. Khazai, A. Rosen, S. Triche, and V. Tangpricha Prevalence of Vitamin D Insufficiency in Patients With Parkinson Disease and Alzheimer Disease Arch Neurol, October 1, 2008; 65(10): 1348 - 1352. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Sato, Y. Honda, and J. Iwamoto Risedronate and ergocalciferol prevent hip fracture in elderly men with Parkinson disease Neurology, March 20, 2007; 68(12): 911 - 915. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B H Wood, J A Bilclough, A Bowron, and R W Walker Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study J. Neurol. Neurosurg. Psychiatry, June 1, 2002; 72(6): 721 - 725. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Lips Vitamin D Deficiency and Secondary Hyperparathyroidism in the Elderly: Consequences for Bone Loss and Fractures and Therapeutic Implications Endocr. Rev., August 1, 2001; 22(4): 477 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Sato, M. Kaji, K. Oizomi, and F. Cosman An alternative to vitamin D supplementation to prevent fractures in patients with MS Neurology, July 1, 1999; 53(2): 437 - 437. [Full Text]
|
|
|
|
|
|
Y. Sato, S. Manabe, H. Kuno, and K. Oizumi Amelioration of osteopenia and hypovitaminosis D by 1alpha -hydroxyvitamin D3 in elderly patients with Parkinson's disease J. Neurol. Neurosurg. Psychiatry, January 1, 1999; 66(1): 64 - 68. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
