Calcium regulating hormones in healthy elderly men: relation to intestinal calcium absorption

Aged male subjects often have osteoporosis and it has been suggested that the cause is an age-related lack of vitamin D. We evaluated the calcium regulating endocrine mechanism in healthy aged males in order to verify this hypothesis. We studied serum levels of PTH and 1,25(OH)2D in relation to intestinal calcium absorption, radial bone mass density (BMD) and osteocalcin plasma levels in 30 healthy elderly men (61-88 yr.). 1,25(OH)2D levels and calcium absorption, assessed by oral strontium test, did not change with age with respect to a young control group. PTH was higher (p < 0.02) in the elderly than in the control group, and correlated positively with nephrogenous cAMP levels (p < 0.01; r = 0.65). Radial BMD (measured by single photon absorptiometry) was lower (p < 0.01) in elderly than in young subjects and negatively correlated with age (p < 0.01; r = -0.45). Osteocalcin levels, used as a mark of bone turnover, were unchanged. The data suggest that decreased 1,25(OH)2D levels are not a feature of normal male aging. Senile hyperparathyroidism could compensate for impairments in endogenous metabolism of vitamin D in elderly males and maintain calcium absorption at an efficient level, without increasing bone turnover.