title: A relationship between vitamin D, parathyroid hormone, calcium levels and lactose intolerance in type 2 diabetic patients and healthy subjects.
abstract: BACKGROUND
  Type 2 diabetes mellitus is chronic metabolic disorder. Common gastrointestinal symptoms in type 2 diabetic patients are flatulence, constipation and/or diarrhea. Reason for these may be lactose intolerance leading to change in vitamin D, Calcium and parathyroid hormone which further regulate bone mineralization.
  
  
  OBJECTIVE
  To measure lactose intolerance, vitamin D, calcium and parathyroid hormone in type 2 diabetic patients.
  
  
  METHODS
  150 type 2 diabetic patients attending Endocrinology Clinic in PGI, Chandigarh and 150 age and sex matched healthy controls were enrolled. Lactose intolerance was measured using non-invasive lactose breath test. 25-hydroxyvitamin D (total) and Parathyroid hormone were measured in plasma using immunoassay. Serum calcium was measured using auto analyzer. T score was recorded from DXA scan for bone mineral density measurement.
  
  
  RESULTS
  Lactose intolerance was observed significantly higher (p<0.001) diabetic patients (59.3%) as compared to controls (42%). Levels of plasma 25-OH vitamin D (total), parathyroid hormone and serum calcium were significantly lower in patients as compared to controls. Furthermore, levels of plasma 25-OH vitamin D (total), parathyroid hormone and serum calcium were more decreased in lactose intolerant diabetic patients than lactose tolerant patients. Sixty seven percent (67%) of diabetic patients suffered from osteoporosis and 20% of controls. Eighty percent (80%) diabetic patients and 16% controls with osteoporosis suffered from lactose intolerance.
  
  
  CONCLUSIONS
  From this study we can conclude that measurement of lactose intolerance using non-invasive lactose breath test is suggested for type 2 diabetic patients along with timely measurement of 25-OH vitamin D (total), calcium and parathyroid hormone levels.
authors.affiliation: Department of Gastroenterology, Post Graduate Institute of Medical Research and Education, Chandigarh 160012, India. Electronic address: svrana25@hotmail.com.
authors.forename: SatyaVati
authors.initials: S
authors.lastname: Rana
authors.affiliation: Department of Gastroenterology, Post Graduate Institute of Medical Research and Education, Chandigarh 160012, India. Electronic address: rajeshmorya1987@gmail.com.
authors.forename: Rajesh Kumar
authors.initials: RK
authors.lastname: Morya
authors.affiliation: Department of Gastroenterology, Post Graduate Institute of Medical Research and Education, Chandigarh 160012, India. Electronic address: malikaastha@gmail.com.
authors.forename: Aastha
authors.initials: A
authors.lastname: Malik
authors.affiliation: Department of Endocrinology, Post Graduate Institute of Medical Research and Education, Chandigarh 160012, India. Electronic address: bhadadask@rediffmail.com.
authors.forename: Sanjay Kumar
authors.initials: SK
authors.lastname: Bhadada
authors.affiliation: Department of Endocrinology, Post Graduate Institute of Medical Research and Education, Chandigarh 160012, India. Electronic address: naresh_sach@rediffmail.com.
authors.forename: Naresh
authors.initials: N
authors.lastname: Sachdeva
authors.affiliation: Department of Gastroenterology, Post Graduate Institute of Medical Research and Education, Chandigarh 160012, India. Electronic address: gauravsharma1285@gmail.com.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Sharma
mesh_terms: D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007787:Lactose Intolerance / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium
keywords: 25-OH vitamin D (total); Calcium; Lactose intolerance; Osteoporosis; Parathyroid hormone; Type 2 diabetes