title: The Effect of Treatment With PTH on Undercarboxylated Osteocalcin and Energy Metabolism in Hypoparathyroidism.
abstract: BACKGROUND
  Undercarboxylated osteocalcin (ucOC) has been shown to affect glucose metabolism in mice. We recently randomized patients with hypoparathyroidism to treatment with PTH or placebo and demonstrated a marked increase in total osteocalcin.
  
  
  OBJECTIVE
  To investigate whether there was a similar increase in ucOC and whether that increase affected glucose metabolism.
  
  
  METHODS
  A 24-week randomized, placebo-controlled trial.
  
  
  METHODS
  Ambulatory patients in a research facility.
  
  
  METHODS
  Sixty-two patients aged 31-78 years with hypoparathyroidism, of which 58 completed the trial.
  
  
  METHODS
  100 μg/d of PTH (1-84).
  
  
  METHODS
  Change in ucOC.
  
  
  RESULTS
  ucOC increased by 1185.0 ± 814.4% (mean ± SD) in the PTH-treated group and by 69.3 ± 79.4% in the placebo group (P < 10(-50)). In addition, body weight decreased by 1.1 ± 4.0% in the treatment group and increased 0.8 ± 2.5% in the placebo group (P = .04). Glucose, adiponectin, leptin, homeostasis model of assessment for insulin resistance, total body fat mass, or truncal fat did not change significantly. In addition, the number of hypercalcemic episodes per patient was 3.7 ± 2.9 (mean ± SD) in the PTH-treated group but only 0.2 ± 0.6 in the placebo group (P < .001). Moreover, there was a significant and negative correlation between the change in ucOC and change in body weight (P = .004) or change in total body fat mass (P = .03), and a negative but nonsignificant correlation between the number of hypercalcemic episodes and percentage change in body weight (r = -0.32; P = .1). Change in ucOC did not significantly correlate with changes in other parameters.
  
  
  CONCLUSIONS
  An explanation for the weight loss may be subtle hypercalcemia in PTH treatment inhibiting appetite. Our data do not support a role for ucOC in energy metabolism in humans.
authors.affiliation: Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Harsløf
authors.affiliation: Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark.
authors.forename: Tanja
authors.initials: T
authors.lastname: Sikjær
authors.affiliation: Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark.
authors.forename: Lotte
authors.initials: L
authors.lastname: Sørensen
authors.affiliation: Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark.
authors.forename: Steen B
authors.initials: SB
authors.lastname: Pedersen
authors.affiliation: Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark.
authors.forename: Leif
authors.initials: L
authors.lastname: Mosekilde
authors.affiliation: Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark.
authors.forename: Bente L
authors.initials: BL
authors.lastname: Langdahl
authors.affiliation: Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Rejnmark
mesh_terms: D000328:Adult; D000368:Aged; D002118:Calcium / Q000627:therapeutic use; D004734:Energy Metabolism / Q000187:drug effects*; D005260:Female; D006801:Humans; D007011:Hypoparathyroidism / Q000188:drug therapy* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood* / Q000737:chemistry; D010281:Parathyroid Hormone / Q000494:pharmacology* / Q000627:therapeutic use*; D010919:Placebos; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D010281:Parathyroid Hormone; D010919:Placebos; D015675:Osteocalcin; D014807:Vitamin D; D002118:Calcium