Df. Nutting et al., OCTREOTIDE ENHANCES POSITIVE CALCIUM BALANCE IN DUCHENNE MUSCULAR-DYSTROPHY, The American journal of the medical sciences, 310(3), 1995, pp. 91-98
Although receptors for somatostatin are found in bone cells, the effec
t of somatostatin analogs on calcium metabolism is unknown. The author
s studied, in a metabolic ward, the effect of octreotide (a long-actin
g somatostatin analog) and a placebo in two 6-day calcium balance peri
ods in 8 children with Duchenne muscular dystrophy. As expected, octre
otide (2 mu g/kg, subcutaneously, every 8 hours) reduced serum growth
hormone and somatomedin (IGF-1) to levels found in growth hormone defi
ciency. Octreotide enhanced calcium retention by 30% (96 mg daily [P <
0.04]) in 7 boys for whom complete data (diet, urine, and fecal calci
um) were available. In 6 children with urinary calcium excretion (U-Ca
) greater than 50 mg daily, octreotide markedly lowered U-Ca, from 114
+/- 23 mg daily to 61 +/- 9 mg daily (P < 0.03). Calcium retention oc
curred in patients with or without initial hypercalciuria, but the hig
her the basal U-Ca, the greater was the inhibition by octreotide (r =
0.79; P < 0.03). Inactive, nonambulatory patients had a more pronounce
d response of U-Ca to octreotide (P < 0.02). Octreotide caused a mild,
nonsignificant reduction in fecal calcium, with no major changes in s
erum calcium, phosphorus, parathyroid hormone, urinary excretion of so
dium and potassium, or in creatinine clearance. Based on the current o
bservations and the presence of receptors for somatostatin in bone cel
ls, this hormone may have, at least on a short-term basis, an anabolic
effect on calcium, perhaps favoring its deposition in bone.