Title: Osteoporosis in hemochromatosis: iron excess, gonadal deficiency, or other factors? Author: Diamond T, Stiel D, Posen S. Journal: Ann Intern Med; 1989 Mar 15; 110(6):430-6. PubMed ID: 2919850. Abstract: STUDY OBJECTIVE: To define the prevalence, severity, type and pathogenesis of osteopenia in idiopathic hemochromatosis. DESIGN: Prospective study conducted over 18 months. SETTING: Tertiary care center. SUBJECTS: Twenty-two men with idiopathic hemochromatosis and 20 age-matched controls. There were 5 hypogonadal patients, 9 eugonadal nonvenesected patients, and 8 eugonadal venesected patients. MEASUREMENTS AND MAIN RESULTS: All patients and controls were evaluated by spinal radiography, spinal and forearm bone mineral density estimations, dynamic skeletal histomorphometry, and serum biochemistry. Ten patients (45%; 95% CI, 24% to 68%) had osteoporosis as defined by spinal and forearm bone density measurements. Trabecular bone volumes were significantly reduced in the patients (the difference in means between patients and age-matched controls was 3.9%; CI, 1.3% to 6.7%). No patient had osteomalacia. Hypogonadal men had lower bone mass measurements than eugonadal men (radial bone density: beta coefficient = -20.5; CI, -29.2 to -11.8; trabecular bone volume: beta coefficient = -7.1; CI, -10.8 to -3.3). Osteoid and osteoblastic surfaces and bone formation rates were significantly greater in the eugonadal venesected compared with the eugonadal nonvenesected persons (P less than 0.05 for all measurements). CONCLUSIONS: A significant decrease in bone density is seen in idiopathic hemochromatosis, particularly when hypogonadism is present. Low serum free-testosterone concentrations rather than the calciotrophic hormones determine bone mass in this condition.[Abstract] [Full Text] [Related] [New Search]
