Changes in Bone Mineral Density Following Conventional Oral Phosphonate Treatment of Hypophosphatemic Osteomalacia: A Non-Randomized Controlled Study

Figures & data

Table 1 Distribution of Demographic and Biochemical Data of Patients According to Sex

Sex	n	Height (cm)	Weight (kg)	Serum P (mmol L^−1)	Serum Ca (mmol L^−1)	Serum ALP (u L^−1)	PTH (pmol L^−1)
Patients
Males	13	161.1 ± 8.7	60.4 ± 8.6	0.59 ± 0.18	2.02 ± 0.32	235.83 ± 83.56	9.94 ± 5.82
Females	8	140.8 ± 18.2	52.7 ± 22.0	0.60 ± 0.22	2.10 ± 0.29	244.43 ± 65.31	14.68 ± 4.13
Total	21	153.0 ± 16.4	57.3 ± 154	0.59 ± 0.18	2.05 ± 0.30	238.95 ± 74.08^b	11.04 ± 5.71^b
Controls
Males	65	163.8 ± 4.5	62.7 ± 6.5	1.16 ±0.11	2.18 ± 0.09	75.99 ± 19.60	3.88 ± 1.38
Females	40	152.5 ± 5.6	52.1 ± 9.0	1.12 ± 0.13	2.22 ± 0.11	72.31 ± 26.98	3.86 ± 1.26
Total	105	159.5 ± 7.4	58.7 ± 9.1	1.14 ± 0.12	2.20 ± 0.10	74.08 ± 23.34	3.87 ± 1.30

Note: ^bP < 0.01.

Abbreviations: P, phosphorus; Ca, calcium; ALP, alkaline phosphatase; PTH, parathyroid hormone.

Table 2 Distribution of BA, BMC and BMD Data in Different Sites for Patient and Control Groups

Measurements	Patient (n = 21)	Controls (n = 105)	P value
L1-L4
BA (cm^2)	57.22 ± 5.29	58.15 ± 7.46	0.200
BMC (g)	47.07 ± 15.48	52.86 ± 11.85	0.048^a
BMD (g cm^−2)	0.807 ± 0.256	0.901 ± 0.126	0.000^b
Femur Neck
BA (cm^2)	5.07 ± 0.58	5.04 ± 0.46	0.459
BMC (g)	3.07 ± 1.04	3.84 ± 0.73	0.041^a
BMD (g cm^−2)	0.589 ± 0.173	0.759 ± 0.117	0.031^a
Total Hip
BA (cm^2)	37.78 ± 5.55	35.79 ± 5.17	0.774
BMC (g)	25.57 ± 8.69	31.87 ± 7.59	0.796
BMD (g cm^−2)	0.673 ± 0.184	0.854 ± 0.129	0.014^a

Notes: ^aP < 0.05; ^bP < 0.01.

Abbreviations: L1–L4, lumbar spine; BA, Bone area; BMC, bone mineral content; BMD, bone mineral density.

Table 3 Correlation Between Serum P, Ca and ALP Levels and BMD at Different Anatomical Sites

	L1–L4		Femur Neck		Total
	r	P value	r	P value	r	P value
Serum P	0.135	0.605	0.575	0.044^a	0.109	0.699
Serum Ca	–0.207	0.425	–0.392	0.120	–0.415	0.124
Serum ALP	0.478	0.137	0.665	0.175	0.469	0.203

Note: ^aP < 0.05.

Abbreviations: P, phosphorus; Ca, calcium; ALP, alkaline phosphatase; BMD, bone mineral density; L1–L4, lumbar spine.

Figure 1 Observed BMD changes of HO patients after different treatments. BMD of L1–L4, the femoral neck and the total hip significantly increased (P < 0.01) after continuous treatment with a neutral phosphate solution (group A). There was no significant improvement in the BMD after intermittent treatment with a neutral phosphate solution (group B, P > 0.05). Patients not treated with a neutral phosphate solution showed decreased BMD (group C, P < 0.05).