0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Osteoporosis in Hemochromatosis: Iron Excess, Gonadal Deficiency, or Other Factors?

Terrence Diamond, MB; Daniel Stiel, MD; and Solomon Posen, MD
[+] Article and Author Information

Grant Support: Supported in part by the Edwards Research Fund.

Requests for Reprints: Solomon Posen, MD, Department of Endocrinology, Royal North Shore Hospital, St. Leonards, Sydney 2065, New South Wales, Australia.

Current Author Addresses: Drs. Diamond, Stiel, and Posen: Royal North Shore Hospital, St. Leonards, Sydney 2065, New South Wales, Australia.


©1989 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1989;110(6):430-436. doi:10.7326/0003-4819-110-6-430
Text Size: A A A

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 fore-arm 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 < 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.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)