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The Effects of Thiazide Diuretics on Calcium Metabolism in the Aged
- Source :
- Journal of the American Geriatrics Society. 41:818-822
- Publication Year :
- 1993
- Publisher :
- Wiley, 1993.
-
Abstract
- Objective: To determine the effects of long-term use of the thiazide diuretic chlorthalidone on serum bone-related biochemical variables in older persons. Design: Cross-sectional comparison. Setting: Community-dwelling subjects who had participated in the Systolic Hypertension in the Elderly (SHEP) program. Participants: Sixty-six Caucasians (36 male and 30 female), age range 70 to 89 years, of whom 23 were taking a thiazide diuretic. Measurements: 25-hydroxyvitamin D (25OHD), parathyroid hormone, osteocalcin, calcitonin, and serum bioavailable testosterone. Results: In both groups, there was a high prevalence of low 25 (OHD) levels (30%). Log 25OHD showed a significant inverse relationship to parathyroid hormone (r = .33, P < 0.05). Thiazide users had lower levels of osteocalcin (P < 0.05) and parathyroid hormone levels (P < 0.05) compared with non-thiazide users. Male thiazide users had decreased bioavailable testosterone levels compared with non-thiazide users (P < 0.05). Serum osteocalcin was significantly related to bioavailable testosterone in men not on thiazide (r = .43, P < 0.05). Conclusions: Hypovitaminosis D is a common finding in older individuals with associated elevations in parathyroid hormone. Parathyroid hormone and testosterone concentration (in men) are correlated with serum osteocalcin, a measure of osteoblastic activity. Long-term thiazide use alters these relationships and produces a biochemical profile suggestive of decreased bone formation. Reduced bioavailable testosterone may also play a role in these biochemical changes.
- Subjects :
- Calcitonin
Male
medicine.medical_specialty
medicine.medical_treatment
Osteocalcin
Biological Availability
Parathyroid hormone
Sex Factors
Internal medicine
Prevalence
Humans
Medicine
Testosterone
Thiazide
Aged
Aged, 80 and over
Calcium metabolism
biology
Hydroxycholecalciferols
business.industry
Age Factors
Chlorthalidone
Cross-Sectional Studies
Endocrinology
Parathyroid Hormone
biology.protein
Drug Evaluation
Female
Bone Diseases
Geriatrics and Gerontology
Diuretic
business
medicine.drug
Subjects
Details
- ISSN :
- 00028614
- Volume :
- 41
- Database :
- OpenAIRE
- Journal :
- Journal of the American Geriatrics Society
- Accession number :
- edsair.doi.dedup.....d512d70e8679302e4f89b3b1a5f7dc48