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Measurement of the Kinetics of Calcium Metabolism in Children and Adolescents Utilizing Nonradioactive Strontium¹

Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania School of Medicine Philadelphia, Pennsylvania

Studies of the kinetics of calcium metabolism utilizing nonradioactive strontium as a tracer for calcium are reported in normal children and in children with diseases affecting mineral and skeletal metabolism. In 15 children without evidence of abnormality of calcium or bone metabolism the exchangeable pool of strontium, the turnover rate and the bone deposition rate of strontium increased with the age and surface area of the subject, reaching a maximum in the adolescent and decreasing thereafter to the adult range. An expanded exchangeable pool of strontium and increased turnover and bone deposition rates were observed in children with hyperthyroidism and polyostotic fibrous dysplasia. Children with either vitamin D sensitive or vitamin D resistant rickets had enlarged exchangeable strontium pools while the turnover and bone deposition rates fell within the normal range for their age and body size. In children with hypopituitarism, osteogenesis imperfecta and after prolonged treatment with glucocorticoids, the exchangeable pool of strontium and the turnover and bone deposition rates were found to be decreased. The exchangeable strontium pool, turnover and bone deposition rates were normal in children with aseptic necrosis of the femoral head, cerebral palsy, nonparalytic poliomyelitis and congenital infantile hypoparathyroidism. An adolescent male who fractured his femur and developed hypercalcemia secondary to immobilization was studied serially. The initial investigation revealed a decreased exchangeable pool of strontium and a decreased bone deposition rate. With ambulation the serum calcium concentration returned to normal and there was a progressive increase in the exchangeable strontium pool. The turnover rate increased transiently after mobilization and then returned to its initial value. The bone deposition rate increased acutely after mobilization and remained constant in subsequent studies.

¹ Presented in part at the meeting of the American Pediatric Society, Seattle, Washington, 1964 (1).

Supported by USPHS Grants HD 00371, 2 TIAM 5197 and AM 2662, and by The Upjohn Company. Portions of these studies were conducted in the Clinical Research Center of the Children's Hospital of Philadelphia, supported by USPHS Grant 1M01 FR-00240.

Received November 15, 1965.

Accepted January 29, 1966.

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