Effect of metabolic control on parathyroid hormone secretion in diabetic patients

The metabolic derangement caused by diabetes mellitus may potentially affect bone mineral metabolism. In the present study we evaluated the effect of diabetes metabolic control on parathyroid hormone (PTH) secretion during stimulation with EDTA infusion. The study was conducted on 24 individuals, 8 of them normal subjects (group N: glycated hemoglobin - HbA1C = 4.2 + or - 0.2 percent; range = 3.5-5.0 percent), 8 patients with good and regular metabolic control (group G-R: HbA1C = 7.3 + or - 0.4 percent; range = 6.0-8.5 percent), and 8 patients with poor metabolic control (group P: HbA1C = 12.5 + or - 1.0 percent; range: 10.0-18.8 percent). Blood samples were collected at 10-min intervals throughout the study (a basal period of 30 min and a 2-h period of EDTA infusion, 30 mg/kg body weight) and used for the determination of ionized calcium, magnesium, glucose and intact PTH. Basal ionized calcium levels were slightly lower in group P (1.19 + or - 0.01 mmol/l) than in group N (1.21 + or - 0.01 mmol/l) and group G-R (1.22 + or - 0.01 mmol/l). After EDTA infusion, the three groups presented a significant fall in calcium, but with no significant difference among them at any time. Basal magnesium levels and levels determined during EDTA infusion were significantly lower (P<0.01) in group P than in group N. The induction of hypocalcemia caused an elevation in PTH which was similar in groups N and G-R but significantly higher than in group P throughout the infusion period (+110 min, N = 11.9 + or - 2.1 vs G-R = 13.7 + or - 1.6 vs P = 7.5 + or - 0.7 pmol/l; P<0.05 for P vs N and G-R). The present results show that PTH secretion is impaired in patients with poorly controlled diabetes

Zinco na desnutricao proteico-calorica.I. Concentracao no soro de criancas com os tipos clinicos kwashiorkor e kwashiorkor-marasmatico. / Zinc in protein-calorie malnutrition. I. Concentration in serum of children with clinical features of kwashiorkor and marasmatic kwashiorkor

Foram determinadas as concentracoes sericas de zinco em 10 criancas com desnutricao proteico-calorica (oito com tipo clinico kwashiorkor e duas com o tipo kwashiorkor-marasmatico), no primeiro, decimo quinto e trigesimo dias de internaco. Nestes pacientes os niveis de zinco, no primeiro dia foram significativamente inferiores aqueles observados em criancas com bom estado nutricional. Durante o periodo inicial de recuperacao do estado nutricional, nao houve aumento significativo da concentracao deste oligoelemento no soro. E discutida a possibilidade de suplementacao deste cation durante a recuperacao de criancas desnutridas