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High incidence of obesity and elevated serum immunoreactive insulin level in patients with paravertebral ligamentous ossification: A relationship to the development of ectopic ossification

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Abstract

Insulin has been shown to stimulate bone formation, and there is a high incidence of obesity and disturbance in the glucose metabolism of patients with paravertebral ligamentous ossification (PVLO). In an effort to clarify whether there is any alteration in insulin status in PVLO patients, and whether such changes play any role in the development of PVLO, glucose metabolism and serum insulin levels are examined in 11 PVLO patients and compared with 6 control patients of similar age and activities of daily living. More than half of the patients with PVLO exceed 110% of ideal body weight, and their fasting serum immunoreactive insulin (IRI) levels are significantly higher than those of control patients. In addition, there is a significant correlation between fasting IRI and % ideal body weight in PVLO patients. These results indicate that hyperinsulinism is present in many patients with PVLO, and that obesity further aggravates the hyperinsulinism in this disorder. Thus, it is suggested that hyperinsulinism is involved in the development or aggravation of ectopic ossification in PVLO patients. The relationship between hyperinsulinism and the other factors such as genetic and physical factors as well as the changes in calcium metabolism in the development of PVLO remains to be clarified.

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References

  1. Tsukimoto H. On an autopsied case of compression myelopathy with a callus formation in the cervical spinal canal. Nihon Geka-Hokan 29, 1003–1007, 1960 (in Japanese).

    Google Scholar 

  2. Tsuyama N, Terayama K, Ohtani K, Yamauchi Y, Yamamura I, Kurokawa T, Tomita A, Kirita Y, Ono K, Kataoka O, Ikata T, Sato T, Hattori S, Tsuzuki N, Hirabayashi K, Sasaki T, Yanagi T, Tominaga S, Tezuka A and Nagai Y. The ossification of the posterior longitudinal ligaments of the spine (OPLL). J. Jpn. Orthop. Assoc. 55, 425–440, 1981.

    Google Scholar 

  3. Rasmussen H and Anast C. Familial hypophosphatemic rickets and vitamin D-dependent rickets. In: Stanbury JB, Wyngaarden JB, Goldstein JL and Brown MS (eds). The Metabolic Basis of Inherited Diseases. McGraw-Hill, New York, pp. 1743–1773, 1983.

    Google Scholar 

  4. Okazaki T, Takuwa Y, Yamamoto M, Matsumoto T, Igarashi T, Kurokawa T and Ogata E. Ossification of the paravertebral ligaments: a frequent complication of hypoparathyroidism. Metabolism 33, 710–713, 1984.

    Article  CAS  PubMed  Google Scholar 

  5. Matsumoto T, Takuwa Y, Okazaki T, Hoshino Y, Iizuka M, Kurokawa T, Hata K and Ogata E. Association of paravertebral ligamentous ossification with hypoparathyroidism. In: Cohn DV, Fujita T, Potts JT and Talmage RV (eds). Endocrine Control of Bone and Calcium Metabolism. Elsevier Scientific Publishers B.V., Amsterdam, pp. 26–31, 1984.

    Google Scholar 

  6. Takuwa Y, Matsumoto T, Kurokawa T, Iizuka M, Hoshino Y, Hata K and Ogata E. Calcium metabolism in paravertebral ligamentous ossification. Acta Endocrinol. 109, 428–432, 1985.

    CAS  PubMed  Google Scholar 

  7. Kawagishi T and Harada M. Studies of the prevalence of the ossification of the posterior longitudinal ligament of the cervical spine in diabetic patients. Clin. Orthop. Surg. 14, 718–722, 1979.

    Google Scholar 

  8. Henry HL. Insulin permits parathyroid hormone stimulation of 1,25-dihydroxyvitamin D3 production in cultured kidney cells. Endocrinology 108, 733–735, 1981.

    CAS  PubMed  Google Scholar 

  9. Frazer TE, White NH, Hough S, Santiago JV, McGee BR, Bryce G, Mallon J and Avioli LV. Alterations in circulating vitamin D metabolites in the young insulin-dependent diabetes. J. Clin. Endocrinol. Metab. 53, 1154–1159, 1981.

    CAS  PubMed  Google Scholar 

  10. Matsumoto T, Kawanobe Y, Ezawa I, Shibuya N, Hata K and Ogata E. Role of insulin in the increase in serum 1,25-dihydroxyvitamin D concentration in response to phosphorus deprivation in streptozotocin-induced diabetic rats. Endocrinology 118, 1440–1444, 1986.

    CAS  PubMed  Google Scholar 

  11. Levin ME, Boisseau VC and Avioli LV. Effects of diabetes mellitus on bone mass in juvenile and adult-onset diabetes. N. Engl. J. Med. 294, 241–245, 1976.

    CAS  PubMed  Google Scholar 

  12. Hough S, Avioli LV, Bergfeld MA, Fallon MD, Slatopolsky E and Teitelbaum SL. Correction of abnormal bone and mineral metabolism in chronic streptozotocin-induced diabetes mellitus in the rat by insulin therapy. Endocrinology 108, 2228–2234, 1981.

    CAS  PubMed  Google Scholar 

  13. Kawanobe Y, Matsumoto T, Takano K, Ezawa I and Ogata E. Adaptation to phosphorus depletion: effect of streptozotocin-induced diabetes mellitus. Acta Endocrinol. 110, 120–123, 1985.

    CAS  PubMed  Google Scholar 

  14. Raisz LG and Kream BE. Regulation of bone formation. N. Engl. J. Med. 309, 83–89, 1983.

    CAS  PubMed  Google Scholar 

  15. Canalis EM, Detrich JW, Maina DM and Raisz LG. Hormonal control of bone collagen synthesisin vitro: effects of insulin and glucagon. Endocrinology 100, 668–674, 1977.

    CAS  PubMed  Google Scholar 

  16. Kream BE, Smith MD, Canalis E and Raisz LG. Characterization of the effect of insulin on collagen synthesis in fetal rat bone. Endocrinology 116, 296–302, 1985.

    CAS  PubMed  Google Scholar 

  17. Peck WA and Messinger K. Nucleoside and ribonucleic acid metabolism in isolated bone cells: effects of insulin and cortisolin vitro. J. Biol. Chem. 245, 2722–2729, 1975.

    Google Scholar 

  18. Ono K, Ota H, Tada K, et al. Ossified posterior longitudinal ligament. A clinicopathologic study. Spine 2, 126–138, 1977.

    Google Scholar 

  19. Resnick D, Guerra J, Robinson CA and Vint VC. Association of diffuse idiopathic skeletal hyperostosis (DISH) and calcification and ossification of the posterior longitudinal ligament. Am. J. Roentgenol. 131, 1049–1053, 1978.

    CAS  Google Scholar 

  20. Littlejohn GO. Insulin and new bone formation in diffuse idiopathic skeletal hyperostosis. Clin. Rheumatol. 4, 294–300, 1985.

    Article  CAS  PubMed  Google Scholar 

  21. Bell NH, Epstein S, Green A, Shary J, Oexmann MJ and Shaw S. Evidence for alteration of vitamin D-endocrine system in obese subjects. J. Clin. Invest. 76, 370–373, 1985.

    CAS  PubMed  Google Scholar 

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Takeuchi, Y., Matsumoto, T., Takuwa, Y. et al. High incidence of obesity and elevated serum immunoreactive insulin level in patients with paravertebral ligamentous ossification: A relationship to the development of ectopic ossification. J Bone Miner Metab 7, 17–21 (1989). https://doi.org/10.1007/BF02377578

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