Octreotide enhances positive calcium balance in Duchenne muscular dystrophy.
Although receptors for somatostatin are found in bone cells, the effect of somatostatin analogs on calcium metabolism is unknown. The authors studied, in a metabolic ward, the effect of octreotide (a long-acting somatostatin analog) and a placebo in two 6-day calcium balance periods in 8 children with Duchenne muscular dystrophy. As expected, octreotide (2 micrograms/kg, subcutaneously, every 8 hours) reduced serum growth hormone and somatomedin (IGF-1) to levels found in growth hormone deficiency. Octreotide enhanced calcium retention by 30% (96 mg daily [P < 0.04]) in 7 boys for whom complete data (diet, urine, and fecal calcium) were available. In 6 children with urinary calcium excretion (Uca) greater than 50 mg daily, octreotide markedly lowered Uca, from 114 +/- 23 mg daily to 61 +/- 9 mg daily (P < 0.03). Calcium retention occurred in patients with or without initial hypercalciuria, but the higher the basal Uca, the greater was the inhibition by octreotide (r = 0.79; P < 0.03). Inactive, nonambulatory patients had a more pronounced response of Uca to octreotide (P < 0.02). Octreotide caused a mild, nonsignificant reduction in fecal calcium, with no major changes in serum calcium, phosphorus, parathyroid hormone, urinary excretion of sodium and potassium, or in creatinine clearance. Based on the current observations and the presence of receptors for somatostatin in bone cells, this hormone may have, at least on a short-term basis, an anabolic effect on calcium, perhaps favoring its deposition in bone.
Nutting
D F
DF
Department of Physiology, College of Medicine, University of Tennessee, Memphis 38163, USA.
Schriock
E A
EA
Palmieri
G M
GM
Bittle
J B
JB
Elmendorf
B J
BJ
Horner
L H
LH
Edwards
M C
MC
Griffin
J W
JW
Sacks
H S
HS
Bertorini
T E
TE
D000293:Adolescent; D002118:Calcium / Q000378:metabolism* / Q000652:urine; D002648:Child; D004032:Diet; D004064:Digestive System / Q000378:metabolism; D013006:Growth Hormone / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007408:Intestinal Absorption / Q000187:drug effects; D008297:Male; D009136:Muscular Dystrophies / Q000378:metabolism*; D015282:Octreotide / Q000008:administration & dosage / Q000494:pharmacology*; D010710:Phosphates / Q000652:urine
D010710:Phosphates; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D015282:Octreotide; D002118:Calcium