Ca&Bone

[Evaluation of bone mineralization in cow’s milk sensitive children]

HIDVÉGI Edit és munkatársai

APRIL 20, 2002

Ca&Bone - 2002;5(01-02)

[BACKGROUND - Patients with cow's milk allergy (CMA) form a potential risk group for osteopenia, because their milk-free diet usually has a low calcium content.The study analyses various parameters of bone mineralization in CMA children. PATIENTS AND METHODS - Twenty-seven CMA patients (mean age: 4.3 years, range: 3-8 years) were enrolled in the study.Transient sensitivity to cow's milk was observed in 20 of 27 patients. During the milk-free diet period (mean duration 11.8 months) children were fed by extensively hydrolysed or soy-based formulas. Seven patients still required a cow's milk free diet at the time of the study. Serum levels of Na, K, Cl, Ca, P and Mg ions, as well as of alkaline phosphatase (AP), parathyroid hormone (PTH), osteocalcin and beta-crosslaps were determined for all 27 patients.The values were compared to those of 20 healthy age-matched controls. Bone mineral densities (BMDs) of CMA patients were also measured. RESULTS - The AP and PTH levels were higher in CMA patients than in the control group (AP: 610.2 U/l vs 499.7 U/l, p<0.01; PTH: 1.56 pmol/l vs 0.83 pmol/l, p<0.03), but all values fell in the normal range.The osteocalcin level was similar in the two groups, and the beta-crosslaps was lower in CMA patients than in the controls (0.92 vs 1.47 ng/ml, p<0.001).There was a positive correlation between both AP and osteocalcin and AP and beta-crosslaps levels.The mean Z score of bone mineral density in patients with CMA was -0.6. In 10 cases the Z score was below -1, which was associated with a significantly elevated PTH level compared to the group of patients with a Z score above - 1 (2.24 pmol/l vs 1.16 pmol/l, p<0.03). CONCLUSION - In children with CMA on a cow's milk free diet, slight disturbances of bone mineralization were observed, therefore, osteodensitometric check-up of these children is recommended.]

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[Vitamin D receptor gene BsmI polymorphism in rheumatoid arthritis and associated osteoporosis - Experimental data]

RASS Péter és munkatársai

[AIM: Rheumatoid arthritis (RA) is commonly associated with secondary osteoporosis.The BsmI polymorphism of the vitamin D receptor (VDR) gene has been implicated in the pathogenesis of osteoporosis. However, little data is available on the relationship between rheumatoid arthritis and the BsmI polymorphism. In this study, Hungarian frequencies of BsmI polymorphism genotypes were compared with those found in other countries. METHODS: In this study, 64 RA patients and 40 healthy controls were tested for VDR gene BsmI polymorphism genotypes.The frequencies of the B and b alleles were correlated with densitometric and laboratory markers of bone metabolism as well as with laboratory markers of arthritis. RESULTS: Among control subjects, the frequency of the BB genotype (27,5%) was relatively higher than in other European populations. In RA patients with secondary osteopenia/osteoporosis the BB genotype was rarer, while the bb was more common than in control subjects. Markers of bone metabolism showed that the presence of the B allele in RA patients was associated with a lower bone mineral density and an increased bone loss, while the bb genotype was associated with a higher bone mineral content. An increased osteoclast and osteoblast activity was observed in patients with the B allele, as determined by biochemical markers of bone metabolism. Rheumatoid factor titer, an important laboratory marker of disease progression in RA, was significantly higher in bb patients compared to patients carrying the B allele. CONCLUSION: Our data suggest that the imbalance in B and b allele expression may be involved in the pathogenesis of osteoporosis and perhaps of rheumatoid arthritis.]

Ca&Bone

[Bibliography of Hungarian literature on calcium and bone metabolism, 2001]

TÓTH EDIT

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[Dear Colleagues and Readers!]

HORVÁTH CSABA

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[FORTHCOMING CONGRESS]

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