BONE METABOLISM, PARATHYROID-HORMONE, AND CALCITONIN IN PARAPLEGIA

In paraplegia, osteoporosis below the neurological lesion occurs early after the spinal cord affection. The serum levels of parathyroid hormone (PTH) and calcitonin (CT), using a radioimmunoassay for the measurement of immunoreactivity, were studied in 12 paraplegic patients for 9 months following onset. Serum Ca and P levels, urinary hydroxyproline excretion, and the kinetic metabolic clearance of45Ca have also been measured. P and immunoreactive (i) CT levels were found the highest at the beginning of the observation and progressively decreased with time. Ca and iPTH serum levels varied inversely with time, the highest level of Ca and the lowest level of iPTH being recorded at the third month following the paraplegia. Mean values of Ca, iPTH, and iCT were in the normal range throughout the study. P levels were increased during the first 3 months. Hydroxyprolinuria was also high and45Ca kinetics showed increased values of Vt, Vo+, and Vu. These parameters indicate a high degree of bone turnover. The results were consistent with the assumption that PTH is not responsible for the increased resorption of bone in paraplegia. Likewise, a deficiency of CT does not seem to be responsible for this bone resorption. These endocrine modifications could be secondary to an increase in the calcium flux from bone to blood and resulting from bone destruction as attested by the increase of urinary calcium and urinary hydroxyproline excretion. © 1979 Springer-Verlag.