Osteocalcin and multiple scanning X-ray photodensitometry (MD/MS) for postoperative hypoparathyroidism treated with vitamin D3.

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In order to rule out low-grade osteoporosis in postoperative hypoparathyroidism patients treated with activated vitamin D3, we examined (1) the midportion of parathyroid hormone (M-PTH, relatively stable compared to other PTH), (2) osteocalcin (osteoblast producing Gla protein), (3) multiple scanning X-ray photodensitometry (MD/MS method, using X-ray film of secondary metacarpal bone with alminium steps).Sixteen patients were examined: 13 of a series of 45 who had had total thyroidectomy and 3 of a series of 49 who had had subtotal thyroidectomy. In spite of normal serum calcium levels, 9 patients were diagnosed as osteoporosis by the MD/MS methods. Increasing of the vitamin D3 dose reduced the lower-grade osteoporosis in these patients within 3-4 months.It is concluded that osteocalcin and the MD/MS methods are useful in demonstrating mild osteoporosis in patients with postoperative hypoparathyroidism, in spite of normal serum calcium levels. We can monitor the doses of vitamin D3 during long term therapy with the use of these examinations.
耳鼻咽喉科臨床学会の論文