title: Endocrine function in 97 patients with myotonic dystrophy type 1.
abstract: The aim of this study was to investigate the endocrine function and its association to number of CTG repeats in patients with myotonic dystrophy type 1 (DM1). Concentration of various hormones and metabolites in venous blood was used to assess the endocrine function in 97 patients with DM1. Correlation with CTG(n) expansion size was investigated with the Pearson correlation test. Eighteen percent of the DM1 patients had hyperparathyroidism with increased PTH compared with 0.5% in the background population. Of these, 16% had normocalcemia and 2% had hypercalcemia. An additional 3% had hypercalcemia without elevation of PTH; 7% had abnormal TSH values (2% subnormal and 5% elevated TSH levels); 5% of the patients had type 2 diabetes mellitus; 17% of the male DM1 patients had increased LH and low levels of plasma testosterone indicating absolute androgen insufficiency. Another 21% had increased LH, but normal testosterone levels, indicating relative insufficiency. Numbers of CTG repeats correlated directly with plasma PTH, phosphate, LH, and tended to correlate with plasma testosterone for males. This is the largest study of endocrine dysfunction in a cohort of Caucasian patients with DM1. We found that patients with DM1 have an increased risk of abnormal endocrine function, particularly calcium metabolism disorders. However, the endocrine dysfunction appears not to be of clinical significance in all of the cases. Finally, we found correlations between CTG(n) expansion size and plasma PTH, phosphate, and testosterone, and neck flexion strength.
authors.affiliation: Neuromuscular Research Unit 3342, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark. rh10679@rh.dk
authors.forename: M C
authors.initials: MC
authors.lastname: Ørngreen
authors.forename: P
authors.initials: P
authors.lastname: Arlien-Søborg
authors.forename: M
authors.initials: M
authors.lastname: Duno
authors.forename: J M
authors.initials: JM
authors.lastname: Hertz
authors.forename: J
authors.initials: J
authors.lastname: Vissing
mesh_terms: D000293:Adolescent; D000328:Adult; D002118:Calcium / Q000378:metabolism; D002386:Cataract / Q000209:etiology; D004252:DNA Mutational Analysis; D003919:Diabetes Insipidus / Q000209:etiology; D004700:Endocrine System Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006728:Hormones / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D009223:Myotonic Dystrophy / Q000150:complications* / Q000235:genetics; D010281:Parathyroid Hormone / Q000235:genetics; D012737:Sex Factors; D018911:Trinucleotide Repeats / Q000235:genetics*; D055815:Young Adult
chemical_list: D006728:Hormones; D010281:Parathyroid Hormone; D002118:Calcium