Evidence for 25‐hydroxyvitamin D deficiency as a factor contributing to osteopenia in diabetic patients with idiopathic haemochromatosis

Osteopenia is frequently encountered in the course of idiopathic haemochromatosis. In order to establish the mechanism of this bone disorder, the following parameters were studied in nine diabetic patients wih idiopathic haemochromatosis: (i) the intestinal calcium absorption measured by using a double radiotracer technique; (ii) the bone mineral content (BMC, mg/cm2) determined on the forearm by the Cameron's absorptiometric technique, (iii) the plasma 25 hydroxyvitamin D (25-OH-D ng/ml) by a competitive protein-binding radioassay. The results were compared to those obtained in ten controls and in eight diabetics without haemochromatosis. The patients suffering from haemochromatosis had a significant fall in total fractional absorption of calcium and BMC as compared with controls and diabetics without haemochromatosis. Furthermore plasma 25-OH-D was significantly lower in haemochromatosis patients (5.1 +/- 0.6 ng/ml) than in controls (16.4 +/- 1.3 ng/ml, P less than 0.01) and in diabetics without haemochromatosis (14.2 +/- 1.4 ng/ml, P less than 0.02). These results indicate that haemochromatosis patients exhibit important disturbances in calcium homeostasis, i.e. low concentration of plasma 25-OH-D and reduced intestinal absorption of calcium. The latter abnormalities may well be related to the bone rarefaction observed in these patients.