title: A longitudinal study of total and regional bone mineral content and biochemical markers of bone resorption in patients with idiopathic hypercalciuria on thiazide treatment.
abstract: The effect of thiazides on total body bone mineral content and axial (trunk) and peripheral (arms) bone mass was evaluated. First, dual-energy X-ray absorptiometry was used to study bone mass in 24 patients with idiopathic hypercalciuria and in 22 healthy subjects. Next, the patients were randomized into a group of 14 patients treated with chlorthalidone (50 mg/day) and a group of 10 untreated patients who served as controls; in these two groups biochemical and bone mass studies were repeated 1 year later. Compared with healthy controls, patients with idiopathic hypercalciuria had less bone mass in total body (p < 0.02), arms (p < 0.001), and trunk (p < 0.05). After 1 year, the group of patients treated with thiazides manifested an increase of bone mass in total body (p < 0.0045), arms, and trunk (p < 0.0001) and a decrease in 24-hour calciuria, urinary calcium/creatinine ratio, and serum tartrate resistant acid phosphatase concentration; the untreated group of patients lost bone mass in all three sites. Under baseline conditions, the groups of treated and untreated patients exhibited a negative linear regression between total body bone mass and both urinary calcium/creatinine (r2 = 0.234; p < 0.001) and serum tartrate resistant acid phosphatase concentration (r2 = 0.399; p < 0.0001). Our results confirm the favorable effect of thiazides on bone mass and provide evidence of enhanced bone remodeling in idiopathic hypercalciuria.
authors.affiliation: Department of Medicine, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá de Henares, Madrid, Spain.
authors.forename: H
authors.initials: H
authors.lastname: Rico
authors.forename: M
authors.initials: M
authors.lastname: Revilla
authors.forename: L F
authors.initials: LF
authors.lastname: Villa
authors.forename: I
authors.initials: I
authors.lastname: Arribas
authors.forename: M A
authors.initials: MA
authors.lastname: de Buergo
mesh_terms: D015502:Absorptiometry, Photon; D000135:Acid Phosphatase / Q000097:blood; D000328:Adult; D015415:Biomarkers / Q000032:analysis; D015519:Bone Density / Q000187:drug effects*; D016723:Bone Remodeling; D001862:Bone Resorption / Q000503:physiopathology*; D002118:Calcium / Q000652:urine*; D002752:Chlorthalidone / Q000494:pharmacology / Q000627:therapeutic use*; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012044:Regression Analysis
chemical_list: D015415:Biomarkers; D003404:Creatinine; D000135:Acid Phosphatase; D002752:Chlorthalidone; D002118:Calcium