1986 Fiscal Year Final Research Report Summary
Studies on the pathogenesis, treatment and prevention of glucocorticoid induced osteoporosis in children
| Project/Area Number |
60570422
|
|---|
| Research Category |
Grant-in-Aid for General Scientific Research (C)
|
| Allocation Type | Single-year Grants |
|---|
| Research Field |
Pediatrics
|
|---|
| Research Institution | Chiba University |
|---|
Principal Investigator |
NIIMI Hiroo Department of Pediatrics, Associate Professer, 医学部, 助教授 (40009147)
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
YASUDA Toshiyuki Department of Pediatrics, Research (00211615)
|
|---|
| Project Period (FY) |
1985 – 1986
|
| Keywords | steroid-induced osteoporosis / Jikei University classification / microdensitometric method of the second metacalpal / plasma ionized calcium / 1 <alpha> -hydroxycholecalciferol / hydroxyplorine / parathyroid hormone / カルチトニン |
|---|
| Research Abstract |
In steroid-induced osteoporosis of children, blood biochemical tests almost always gave results in normal range even in serious cases. Among these, plasma ionized calcium showed a good correlation with the severity of osteoporosis according to Jikei classification based on the X-ray picture of the thoracic and lumbar spine, suggesting a usefulness in the early diagnosis of this disease.
Parathyroid hormone in blood (PTH-C,PTH-N) fell in the normal range in each case, so did calcitonin in blood. As a preliminary studies on the treatment and prevention of this disease, a long term administration of a small dose (0.015-0.03 <micro> g/kg/day) of 1 <alpha> -hydroxy-vitamin <D_3> (1 <alpha> <D_3> ) was attempted, expecting an improvement of intestinal calcium absorption and facilitation of bone formation at a small dose level. This regimen was continued for more than 1 year in 13 patients. During the period of administration no abnormalities were noted in the biochemical tests of blood, and urinary Ca/Cr ratio stayed within normal range. Urinary excretion of hydroxyproline was decreased in the second month of administration in all patients in whom the measurement was carried out. The low values persisted thereafter in many patients.
According to the degree of severity by Jikei classification and changes of indices in the microdensitometric evaluation of the second metacarpal, scarcely any changes were seen in the former, without a tendency towards aggravation. No definite trend was found in the changes of various indices in the latter.
In these cases, despite continuous administration of steroid, urinary hydroxyproline excretion was decreased during administration of 1 <alpha> <D_3> , without aggravation of bone changes according to Jikei classification, or any other side effects. Administration of a small dose of 1 <alpha> <D_3> therefore appears to be useful in the treatment and prevention of steroid-induced osteoporosis in children.
|
