{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T02:01:42Z","timestamp":1780624902316,"version":"3.54.1"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Immunological abnormalities, the resulting endocrinopathies, and their treatments\n                    may impact bone health and 25-hydroxyvitamin D (25-OHD) in patients with\n                    autoimmune polyglandular syndromes (APS). Several etiologies contribute to\n                    increased risk for low bone mineral density (BMD), including vitamin D\n                    deficiency. This study evaluated the vitamin D level and BMD of patients with\n                    APS. We performed a cross-sectional study on 44 patients with APS and 55 age and\n                    gender-matched control subjects. Among patients with APS, 14 were classified as\n                    APS-2 [Addison\u2019s disease (AD)+autoimmune thyroid disease (ATD)\n                    and\/or type 1 diabetes(T1D)]. In contrast, the other 30 were APS-3\n                    (ATD+T1D+other autoimmune diseases). Serum samples were analyzed\n                    for vitamin D levels. The lumbar spine and femoral neck BMD were measured by\n                    dual X-ray absorptiometry. Z-scores were obtained by comparison with age- and\n                    gender-matched average values (both patients and controls). The accepted normal\n                    levels were Z-score&gt;\u20131 and\n                    25-OHD&gt;30\u2009ng\/ml. Patients with APS showed 25-OHD levels\n                    and BMD significantly lower than healthy controls (p&lt;0.001 and\n                    p&lt;0.05, respectively). The highest prevalence of abnormal BMD was\n                    observed in the APS-2 subgroup (13 out of 14 patients, 92.6%).\n                    Identifying and treating vitamin D deficiency and low BMD is critical in APS\n                    patients. The fact that the significant endocrine component of APS-2 is AD, and\n                    these patients receive chronic long-term glucocorticoid therapy can be shown as\n                    the reason for this result. However, more extensive prospective controlled\n                    studies are needed to confirm these findings.<\/jats:p>","DOI":"10.1055\/a-2205-2100","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:56:16Z","timestamp":1699318576000},"page":"128-133","source":"Crossref","is-referenced-by-count":2,"title":["Bone Mineral Density and Vitamin D Status in Patients with Autoimmune\n                    Polyglandular Syndromes: A Single Tertiary Care Center\n                    Experience"],"prefix":"10.1055","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7604-0605","authenticated-orcid":false,"given":"Aysen","family":"Akkurt Kocaeli","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Bursa City Hospital, Bursa,\n                    Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erd\u0131nc","family":"Erturk","sequence":"additional","affiliation":[{"name":"Endocrinology, Uludag University Faculty of Medicine, Bursa,\n                    Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,12,6]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s40618-017-0740-9","article-title":"Polyglandular autoimmune syndromes","volume":"41","author":"G J Kahaly","year":"2018","journal-title":"J Endocrinol Invest"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40618-020-01229-1","article-title":"Hegyi Pet al. Prevalence of other autoimmune diseases in polyglandular\n                    autoimmune syndromes type II and III","volume":"43","author":"G Pham-Dobor","year":"2020","journal-title":"J Endocrinol Invest"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/j.1365-2249.2004.02561.x","article-title":"Autoimmune polyglandular syndrome type 2: the tip of an iceberg?","volume":"137","author":"C Betterle","year":"2004","journal-title":"Clin Exp Immunol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s40618-014-0233-z","article-title":"Vitamin D and autoimmunity: what happens in autoimmune polyendocrine\n                    syndromes?","volume":"38","author":"G Bellastella","year":"2015","journal-title":"J Endocrinol Invest"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s11154-016-9405-9","article-title":"Does vitamin D play a role in autoimmune endocrine disorders? A proof of\n                    concept","volume":"18","author":"B Altieri","year":"2017","journal-title":"Rev Endocr Metab Disord"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1017\/S0007114509220824","article-title":"Prevalence of vitamin D deficiency and its relationship with thyroid\n                    autoimmunity in Asian Indians: a community-based survey","volume":"102","author":"R Goswami","year":"2009","journal-title":"Br J Nutr"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/j.dsx.2018.03.007","article-title":"Vitamin D status in diabetic children and adolescents","volume":"12","author":"T Ziaei-Kajbaf","year":"2018","journal-title":"Diabetes Metab Syndr"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1186\/1741-7015-11-171","article-title":"Hospital admissions for vitamin D related conditions and subsequent\n                    immune-mediated disease: record-linkage studies","volume":"11","author":"S V Ramagopalan","year":"2013","journal-title":"BMC Med"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1530\/eje.0.1510193","article-title":"A promoter polymorphism of the CYP27B1 gene is associated with Addison\u2019s\n                    disease, Hashimoto\u2019s thyroiditis, Graves\u2019 disease and type 1\n                    diabetes mellitus in Germans","volume":"151","author":"E R Lopez","year":"2004","journal-title":"Eur J Endocrinol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"2601","DOI":"10.1007\/s00198-017-4097-x","article-title":"Bone mineral density at femoral neck and lumbar spine in adults with type 1\n                    diabetes: a meta-analysis and review of the literature","volume":"28","author":"V N Shah","year":"2017","journal-title":"Osteoporos Int"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/S0140-6736(21)00136-7","article-title":"Adrenal insufficiency","volume":"397","author":"E S Husebye","year":"2021","journal-title":"Lancet"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"e3390","DOI":"10.1002\/dmrr.3390","article-title":"Bone mineral density spectrum in individuals with type 1 diabetes, latent\n                    autoimmune diabetes in adults, and type 2 diabetes","volume":"37","author":"Y Hu","year":"2021","journal-title":"Diabetes Metab Res Rev"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.3390\/jcm9041034","article-title":"Thyroid hormone diseases and osteoporosis","volume":"9","author":"A P Delitala","year":"2020","journal-title":"J Clin Med"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Endocrine Society. Evaluation, treatment, and prevention of vitamin D\n                    deficiency: an Endocrine Society clinical practice guideline","volume":"96","author":"M F Holick","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.jocd.2013.08.004","article-title":"Executive summary of the 2013 International Society for Clinical Densitometry\n                    Position Development Conference on bone densitometry","volume":"16","author":"J T Schousboe","year":"2013","journal-title":"J Clin Densitom"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jocd.2014.01.003","article-title":"Dual-energy X-ray absorptiometry interpretation and reporting in children and\n                    adolescents: the revised 2013 ISCD Pediatric Official Positions","volume":"17","author":"N J Crabtree","year":"2014","journal-title":"J Clin Densitom"},{"key":"ref17","first-page":"65","article-title":"Vitamin D status and its associations with clinical and laboratory parameters in\n                    patients with Addison\u2019s disease","volume":"61","author":"K Zawadzka","year":"2021","journal-title":"Folia Med Cracov"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1530\/EJE-15-1096","article-title":"Reduction in daily HC dosage improves bone health in primary adrenal\n                    insufficiency","volume":"174","author":"J Schulz","year":"2016","journal-title":"Eur J Endocrinol"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1097\/01.med.0000436249.84273.7b","article-title":"Glucocorticoid-related bone changes from endogenous or exogenous\n                    glucocorticoids","volume":"20","author":"A H Warriner","year":"2013","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1210\/er.2018-00097","article-title":"Glucocorticoids and bone: consequences of endogenous and exogenous excess and\n                    replacement therapy","volume":"39","author":"R S Hardy","year":"2018","journal-title":"Endocr Rev"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"264","DOI":"10.36290\/vnl.2021.073","article-title":"Introduction: patients with primary adrenal insufficiency receive long-term\n                    glucocorticoid replacement therapy, which may cause osteoporosis","volume":"67","author":"P Va\u0148uga","year":"2021","journal-title":"Vnitr Lek"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1530\/EJE-08-0880","article-title":"Glucocorticoid replacement therapy and pharmacogenetics in Addison\u2019s\n                    disease: effects on bone","volume":"160","author":"K L\u00f8v\u00e5s","year":"2009","journal-title":"Eur J Endocrinol"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s12020-010-9359-8","article-title":"Co-morbidities, management and clinical outcome of autoimmune Addison\u2019s\n                    disease","volume":"38","author":"L Leelarathna","year":"2010","journal-title":"Endocrine"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1210\/jc.2011-2036","article-title":"Bone mineral density is not significantly reduced in adult patients on low-dose\n                    glucocorticoid replacement therapy","volume":"97","author":"K R Koetz","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1530\/EJE-15-1096","article-title":"Reduction in daily hydrocortisone dose improves bone health in primary adrenal\n                    insufficiency","volume":"174","author":"J Schulz","year":"2016","journal-title":"Eur J Endocrinol"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.ecl.2016.09.007","article-title":"Premenopausal osteoporosis","volume":"46","author":"A Cohen","year":"2017","journal-title":"Endocrinol Metab Clin North Am"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1128\/CDLI.8.4.678-685.2001","article-title":"Celiac disease-associated autoimmune endocrinopathies","volume":"8","author":"V Kumar","year":"2001","journal-title":"Clin Diagn Lab Immunol"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1055\/a-2156-2773","article-title":"Serological screening for celiac disease and gastrointestinal absorption\n                    disorders in patients with autoimmune endocrine diseases","volume":"55","author":"A Akkurt Kocaeli","year":"2023","journal-title":"Horm Metab Res"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s12937-019-0434-6","article-title":"Prevalence of osteoporosis and osteopenia in men and premenopausal women with\n                    celiac disease: a systematic review","volume":"18","author":"R Ganji","year":"2019","journal-title":"Nutr J"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"101616","DOI":"10.1016\/j.beem.2022.101616","article-title":"Acquisition of peak bone mass","volume":"36","author":"T Chevalley","year":"2022","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"ref31","first-page":"585","article-title":"Association of bone mineral density with lean mass, fat mass, and physical\n                    activity in young overweight and obese women","volume":"15","author":"M E Garvey","year":"2022","journal-title":"Int J Exerc Sci"}],"container-title":["Hormone and Metabolic Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2205-2100.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T11:21:39Z","timestamp":1730805699000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2205-2100"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,6]]},"references-count":31,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2024,1,29]]},"published-print":{"date-parts":[[2024,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2205-2100","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"value":"0018-5043","type":"print"},{"value":"1439-4286","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,11,6]]},"published":{"date-parts":[[2023,11,6]]}}}