Bone disease in prolonged parenteral nutrition: Osteopenia without mineralization defect Journal Article


Authors: Shike, M.; Shils, M. E.; Heller, A.; Alcock, N.; Vigorita, V.; Brockman, R.; Holick, M. F.; Lane, J.; Flombaum, C.
Article Title: Bone disease in prolonged parenteral nutrition: Osteopenia without mineralization defect
Abstract: A metabolic bone disease characterized by a mineralization defect, low plasma 1,25(OH)2D, and hypercalciuria has been described in patients receiving prolonged total parenteral nutrition (TPN). Because the practice of TPN differs from center to center, we investigated 13 home TPN patients to determine whether they had similar or different bone abnormalities. They had received TPN for a mean period of 51 ± 38 mo. Bone pain occurred in six patients and two had multiple vertebral and rib fractures (with trauma in one patient). Bone pain was mild to moderate and not incapacitating. Bone histomorphometry showed reduced bone volume, reduced osteoid with normal resorption and calcification rates. These abnormalities were associated with hypercalciuria, but the plasma levels of 1,25(OH)2D were normal. Abnormalities in bone metabolism in this group of patients suggest a fundamental decrease in both matrix-formation rather than a mineralization defect as the underlying mechanism.
Keywords: clinical article; calcium; vitamin d; diagnosis; bone; osteoporosis; therapy; bone disease; parenteral nutrition; human; priority journal
Journal Title: American Journal of Clinical Nutrition
Volume: 44
Issue: 1
ISSN: 0002-9165
Publisher: American Society for Nutrition  
Date Published: 1986-07-01
Start Page: 89
End Page: 98
Language: English
DOI: 10.1093/ajcn/44.1.89
PROVIDER: scopus
PUBMED: 3088971
DOI/URL:
Notes: Article -- Export Date: 18 August 2021 -- Source: Scopus
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  1. Moshe Shike
    168 Shike
  2. Maurice Shils
    16 Shils
  3. Joseph M. Lane
    66 Lane
  4. Nancy Alcock
    23 Alcock