Cross-sectional study of bone metabolism with nutrition in adult classical phenylketonuric patients diagnosed by neonatal screening

Hironori Nagasaka, Hirokazu Tsukahara, Tomozumi Takatani, Yoshitami Sanayama, Masaki Takayanagi, Toshihiro Ohura, Osamu Sakamoto, Tetsuya Ito, Mika Wada, Makoto Yoshino, Akira Ohtake, Tohru Yorifuji, Satoshi Hirayama, Takashi Miida, Hiroki Fujimoto, Hiroshi Mochizuki, Toshikazu Hattori, Yoshiyuki Okano

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33 Citations (Scopus)


The mechanism underlying the development of osteopenia or osteoporosis in longstanding phenylketonuria (PKU) remains to be clarified. We investigated the details of bone metabolism in 21 female and 13 male classical PKU patients aged 20-35 years. Vitamin D (VD), parathyroid hormone (PTH), bone turnover markers, and daily nutrient intake were examined. The patients had lower daily energy and protein intake than did the age-matched controls (22 women, 14 men), but their respective fat, VD, and calcium intake did not differ. Serum 1,25-dihydroxy VD and 25-hydroxy VD levels in female and male patient groups were significantly higher and lower than those in respective control groups (females, P < 0.001; males, P < 0.05 and P < 0.01, respectively). Serum intact PTH levels were significantly higher in the female patient group (P < 0.05). Urinary calcium levels in the patient groups were significantly higher than those of the control subjects (females, P < 0.001; males, P < 0.05). Bone resorption markers were significantly higher in patients than in controls, although bone formation markers were not different. Patient serum levels of osteoprotegerin-inhibiting bone resorption were significantly lower (females, P < 0.001; males, P < 0.01). None of the bone parameters correlated significantly with serum phenylalanine or nutrient intake. PKU patients exhibited lower VD status and more rapid bone resorption despite normal calcium-VD intakes.

Original languageEnglish
Pages (from-to)737-743
Number of pages7
JournalJournal of Bone and Mineral Metabolism
Issue number6
Publication statusPublished - 11-2011
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Endocrinology


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