Endocrine Abstracts

Hydrochloric acid has been demonstrated to be important for the absorption of calcium and the bone loss is often seen in human after total gastrectomy. The aim of our study was to document the change of calcium and bone metabolism in the patients with decreased capacity of gastric acid secretion like chronic atrophic gastritis.

The study sample consisted of chronic atrophic gastritis group and control group. Chronic atrophic gastritis group was 20 post-menopausal females (age: 60.3±5.1 yr) who was confirmed by gastroscopic biopsy, demonstrating atrophic change of gastric mucosal secretory tissue. Control group had 21 healthy females (age: 58.7±6.5 yr) with normal gastroscopic biopsy results. Gastric pH, serum levels of calcium, phosphorus, total alkaline phosphatase, intact PTH, and bone mineral density (Delphi, Hologic, USA) were monitored in all the patients in both group before medication. There were no significant differences of gastric pH (3.9±0.6 vs 3.3±1.0, P>0.05), calcium (8.9±0.9 vs 8.8±1.4 mg/dl, P>0.05), phosphorus (3.2±1.5 vs 3.5±0.9 mg/dl, P>0.05), total alkaline phosphatase (72.5±24.5 vs 60.3±22.4 U/l, P>0.05) and intact PTH (29.3±5.1 vs 27.2±3.8 pg/ml, P>0.05) between chronic atrophic gastritis group and control group. Bone mineral density showed decreased average value in atrophic gastritis group comparing control group (0.78±0.27 vs 0.85±0.31 g/cm², P=0.09).

In conclusion, chronic atrophic gastritis which have lower capacity of gastric acid secretion may cause decrease of bone mineral density. And this mechanism may be one of the pathogenesis of senile osteoporosis.