Low bone mineral density after total gastrectomy in males: a preliminary report emphasizing the possible significance of urinary net acid excretion, serum gastrin and phosphorus

The bone mineral density (BMD) and the associated extracellular status of mineral and acid-base metabolism were evaluated in 11 males, 3-18 years after total gastrectomy (GX). In the lumbar spine, but not in the femoral neck, BMD was decreased in seven, normal in three, and falsely high in one individual. Relative to the limits of normalcy, fasting serum levels of gastrin were low, but normal for calcium, phosphorus, parathyroid hormone, calcitonin and vitamin D, while the level of total alkaline phosphatase was elevated; fasting urine pH and calcium were low, while phosphorus and net acid were high. Regression analyses revealed serum gastrin and phosphorus, and urinary net acid as possible predictors of BMD. It was concluded that over the long-term GX evokes low BMD, but not hyperparathyroidism and deranged vitamin D metabolites. Future studies may focus on gastrin, parathyroid hormone-independent hyperphosphaturia and disturbed acid-base metabolism as indicators of a new extra-cellular equilibrium of minerals.

[Lichen ruber and diabetes mellitus--pathogenetic relations?]

In 177 patients with lichen ruber planus of the oral mucosa and in 177 sex- and age-matched healthy control subjects, the data of 24 laboratory parameters were studied prospectively. Abnormal glucose tolerance was observed in 30.1% of cases and in 11.9% of the control group (P less than or equal to 0.01%). Elevated serum cholesterin levels were found in 35.5% of the lichen ruber patients compared with 17.5% of the control population (P less than or equal to 0.1%). The coexistence of hyperglycemia and hypercholesterolemia was revealed in 11.9% of our lichen ruber patients and in 1.7% of the control group. Similar statistically significant differences in the mentioned parameters were seen in patients with sole skin involvement, as compared to the controls. The possible pathogenetic relationship between lichen ruber and diabetes mellitus is discussed, based on the results of this study.