Role of vitamin D levels and vitamin D supplementation on bone mineral density in Klinefelter syndrome

详细信息    查看全文

• 作者：A. Ferlin ; R. Selice ; A. Di Mambro ; M. Ghezzi ; A. Di Nisio…
• 关键词：Bone mineral density ; Hypogonadism ; Klinefelter ; Osteoporosis ; Vitamin D
• 刊名：Osteoporosis International
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：26
• 期：8
• 页码：2193-2202
• 全文大小：416 KB
• 参考文献：1.Lanfranco F, Kamischke A, Zitzmann M, Nieschlag E (2004) Klinefelter’s syndrome. Lancet 364:273-83PubMed View Article
  2.Klinefelter HF, Reifenstein EC, Albright F (1942) Syndrome characterized by gynecomastia, aspermatogenesis without a-Leydigism, and increased excretion of follicle-stimulating hormone. J Clin Endocrinol Metab 2:615-27View Article
  3.Campbell WA, Price WH (1981) Venous thromboembolic disease in Klinefelter’s syndrome. Clin Genet 19:275-0PubMed View Article
  4.Swerdlow AJ, Higgin CD, Schomaker MJ, Wright AF, Jacobs PA (2005) Mortality in patients with Klinefelter’s syndrome in Britain: a cohort study. J Clin Endocrinol Metab 90:6516-522PubMed View Article
  5.Bojesen A, Gravholt CH (2011) Morbidity and mortality in Klinefelter syndrome (47XXY). Acta Paediatr 100:807-3PubMed View Article
  6.Kübler A, Schulz G, Cordes U, Beyer J, Krause U (1992) The influence of testosterone substitution on bone mineral density in patients with Klinefelter’s syndrome. Exp Clin Endocrinol 100:129-32PubMed View Article
  7.Breuil V, Euller-Ziegler L (2001) Gonadal dysgenesis and bone metabolism. Joint Bone Spine 68:26-3PubMed View Article
  8.van den Bergh JP, Hermus AR, Spruyt AI, Sweep CG, Corstens FH, Smals AG (2001) Bone mineral density and quantitative ultrasound parameters in patients with Klinefelter’s syndrome after long-term testosterone substitution. Osteoporos Int 12:55-2PubMed View Article
  9.Ferlin A, Schipilliti M, Vinanzi C, Garolla A, Di Mambro A, Selice R, Lenzi A, Foresta C (2011) Bone mass in subjects with Klinefelter syndrome: role of testosterone levels and androgen receptor gene CAG polymorphism. J Clin Endocrinol Metab 96(4):739-5View Article
  10.Luisetto G, Mastrogiacomo I, Bonanni G, Pozzan G, Botteon S, Tizian L, Galuppo P (1995) Bone mass and mineral metabolism in Klinefelter’s syndrome. Osteoporos Int 5:455-61PubMed View Article
  11.Bojesen A, Birkeb?k N, Kristensen K, Heickendorff L, Mosekilde L, Christiansen JS, Gravholt CH (2011) Bone mineral density in Klinefelter syndrome is reduced and primarily determined by muscle strength and resorptive markers, but not directly by testosterone. Osteoporos Int 22:1441-0PubMed View Article
  12.Jo DG, Lee HS, Joo YM, Seo JT (2013) Effect of testosterone replacement therapy on bone mineral density in patients with Klinefelter syndrome. Yonsei Med J 54(6):1331-PubMed Central PubMed View Article
  13.Foresta C, Ruzza G, Mioni R, Meneghello A, Baccichetti C (1983) Testosterone and bone loss in Klinefelter syndrome. Horm Metab Res 15:56-7PubMed View Article
  14.Horowitz M, Wishart JM, O’Loughlin PD, Morris HA, Need AG, Nordin BE (1992) Osteoporosis and Klinefelter’s syndrome. Clin Endocrinol (Oxf) 36:113-18View Article
  15.Seo JT, Lee JS, OhTH JKJ (2007) The clinical significance of bone mineral density and testosterone levels in Korean men with non mosaic Klinefelter’s syndrome. BJU Int 99:141-46PubMed View Article
  16.Wong FH, Pun KK, Wang C (1993) Loss of bone mass in patients with Klinefelter’s syndrome despite sufficient testosterone replacement. Osteoporos Int 3:3-PubMed View Article
  17.Battault S, Whiting SJ, Peltier SL, Sadrin S, Gerber G, Maixent JM (2013) Vitamin D metabolism, functions and needs: from science to health claims. Eur J Nutr 52:429-41PubMed View Article
  18.Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477-01PubMed View Article
  19.Choudhary D, Jansson I, Stoilov I, Sarfarazi M, Schenkman JB (2005) Expression patterns of mouse and human CYP orthologs (families 1-) during development and in different adult tissues. Arch Biochem Biophys 436:50-1PubMed View Article
  20.Blomberg Jensen M, Nielsen JE, J?rgensen A, Rajpert-De Meyts E, Kristensen DM, J?rgensen N, Skakkebaek NE, Juul A, Leffers H (2010) Vitamin D receptor and vitamin D metabolizing enzymes are expressed in the human male reproductive tract. Hum Reprod 25:1303-1PubMed View Article
  21.Ferlin A, Selice R, Carraro U, Foresta C (2013) Testicular function and bone metabolism—beyond testosterone. Nat Rev Endocrinol 9:548-4PubMed View Article
  22.Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, Montori VM (2006) Testosterone therapy in adult men with androgen deficiency syndromes: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 91:1995-010PubMed View Article
  23.Grant WB, Holick MF (2005) Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev 10:94-11PubMed
  24.Leib ES, Lewiecki EM, Binkley N, Hamdy RC, International Society for Clinical Densitometry (2004) Official positions of the international society for clinical densitometry. J Clin Densitom 7:1-PubMed View Article
  25.Ferlin A, Schipilliti M, Di Mambro A, Vinanzi C, Foresta C (2010) Osteoporosis in Klinefelter’s syndrome.
• 作者单位：A. Ferlin (1)
  R. Selice (1)
  A. Di Mambro (1)
  M. Ghezzi (1)
  A. Di Nisio (1)
  N. Caretta (1)
  C. Foresta (1)
  
  1. Department of Medicine and Centre for Human Reproduction Pathology, University of Padova, Via Giustiniani 2, 35100, Padova, Italy
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Orthopedics
  Gynecology
  Endocrinology
  Rheumatology
  
• 出版者：Springer London
• ISSN：1433-2965

文摘

Summary This manuscript describes the role of low vitamin D in bone metabolism of Klinefelter subjects. Low vitamin D is frequent in this condition and seems to be more important than testosterone in inducing low bone mineral density (BMD) and osteoporosis. Supplementation with vitamin D restores BMD after 2?years of treatment, whereas testosterone alone seems to be ineffective. Introduction Decreased bone mineral density (BMD) in Klinefelter syndrome (KS) is frequent, and it has been traditionally related to low testosterone (T) levels. However, low BMD can be observed also in patients with normal T levels and T replacement therapy does not necessarily increase bone mass in these patients. Nothing is known about vitamin D levels and supplementation in KS. In this study, we determine vitamin D status and bone mass in KS subjects and compare the efficacy of T therapy and vitamin D supplementation on BMD. Methods A total of 127 non-mosaic KS patients and 60 age-matched male controls were evaluated with reproductive hormones, 25-hydroxyvitamin D, PTH, and bone densitometry by dual-energy X-ray absorptiometry (DEXA). Patients with hypogonadism and/or 25-hydroxyvitamin D deficiency were treated with T-gel 2?% and/or calcifediol and re-evaluated after 24?months of treatment. Results 25-hydroxyvitamin D levels were significantly lower in KS patients with respect to controls, and they had significantly lower lumbar and femoral BMD. The percentage of osteopenia/osteoporosis in subjects with 25-hydroxyvitamin D deficiency was higher with respect to subjects with normal 25-hydroxyvitamin D and was not related to the presence/absence of low T levels. Subjects treated with calcifediol or T + calcifediol had a significant increase in lumbar BMD after treatment. No difference was found in T-treated group. Conclusions These data highlight that low 25-hydroxyvitamin D levels seem to have a more critical role than low T levels in inducing low BMD in KS subjects. Furthermore, vitamin D supplementation seems to be more effective than T replacement therapy alone in increasing BMD.