nach oben

Archives of Osteoporosis

Erschienen in:

01.12.2018 | Original Article

Calcitriol treatment in patients with low vitamin D levels

verfasst von: Refik Tanakol, Nurdan Gül, Ayşe Kubat Üzüm, Ferihan Aral

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

Summary

The aim of the the study is to compare the effects of cholecalciferol and calcitriol on bone mineral metabolism in women with vitamin D deficiency. Calcitriol was associated with a significant increase in bone mineral density at the lumbar spine in patients with low vitamin D levels.

Purpose/introduction

Active vitamin D analogs may have larger impact in decreasing bone loss and fracture rate compared to cholecalciferol in osteoporosis. However, their effects in the treatment of vitamin D deficiency compared to cholecalciferol are not clear. The aim of the present study is to compare the effects of cholecalciferol and calcitriol on bone mineral metabolism and bone mineral density in pre- and postmenopausal women with vitamin D deficiency.

Methods

This was a 6-month prospective, open-label, controlled clinical trial. Eligible 120 participants were pre- and postmenopausal women diagnosed with vitamin D deficiency. Forty-three subjects (group 1) received 1000 IU of cholecalciferol and 1 g of calcium daily. The other 77 subjects (group 2) received 0.5 μg calcitriol in addition to 400 IU of cholecalciferol and 1 g of calcium daily.

Results

Oral vitamin D supplementation did not increase bone mineral density after 6 months of intervention in group 1. On the other hand, bone mineral density at the lumbar spine increased from 0.809 ± 0.172 to 0.848 ± 0.161 g/cm² in group 2 patients (p < 0.017 vs baseline).

Conclusions

Oral daily calcitriol was associated with a significant increase in bone mineral density at the lumbar spine in patients with low vitamin D, elevated PTH, and osteoporosis.

Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281CrossRef

Li X, Liao L, Yan X, Huang G, Lin J, Lei M, Wang X, Zhou Z (2009) Protective effects of 1-α-hydroxyvitamin D3 on residual beta-cell function in adult-onset latent autoimmune diabetes (LADA). Diabetes Metab Res Rev 25:411–416CrossRef

Chapuy MC, Pamphile R, Paris E, Kempf C, Schlichting M, Arnaud S, Garnero P, Garnero P, Meunier PJ (2002) Combined calcium and vitamin D3 supplementation in elderly women: confirmation of reversal of secondary hyperparathyroidism and hip fracture risk: the Decalyos II study. Osteoporos Int 13(3):257–264CrossRef

Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, Chesnut CH, Brown J, Eriksen EF, Hoseyni MS, Axelrod DW, Miller PD (1999) Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis. JAMA 282(14):1344–1352CrossRef

Chesnut CH, Skag A, Christiansen C, Recker R, Stakkestad JA, Hoiseth A, Felsenberg D, Huss H, Gilbride J, Schimmer RC, Delmas PD, and for the oral ibandronate osteoporosis vertebral fracture trial in North America and Europe (Bone) (2004) Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res 19(8):1241–1249CrossRef

Meunier PJ, Slosman DO, Delmas PD, Sebert JL, Brandi ML, Albanese C, Lorenc R, Pors-Nielsen S, De Vernejoul MC, Roces A, Reginster JY (2002) Strontium ranelate: dose dependent effects in established postmenopausal vertebral osteoporosis- a 2-year randomized placebo controlled trial. J Clin Endocrinol Metab 87:2060–2066PubMed

Lau KH, Baylink DJ (1999) Vitamin D therapy of osteoporosis: plain vitamin D therapy versus active vitamin D analog (D-hormone) therapy. Calcif Tissue Int 65:295–306CrossRef

Bischoff-Ferrari HA, Borchers M, Gudat F, Dürmüller U, Stahelin HB, Dick W (2004) Vitamin D receptor expression in human muscle tissue decreases with age. J Bone Miner Res 19:265–269CrossRef

Papadimitropoulos E, Wells G, Shea B (2002) Meta-analysis of the efficacy of vitamin D treatment in preventing osteoporosis in postmenopausal women. Endocr Rev 23:560–569CrossRef

10.

Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2005) Estimates of optimal vitamin D status. Osteoporos Int 16:713–716CrossRef

11.

Genant HK, Jergas M, Palermo L et al (1996) Coomparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis. J Bone Miner Res 11:984–996CrossRef

12.

World Medical Association Declaration of Helsinki (2000) Ethical principles for medical research involving human subjects. JAMA 284:3043–3045CrossRef

13.

Zhang H, Huang Q, Gu J, HU W, Liu Y, Hu Y, Zhang Z (2012) Comparison of the effects of cholecalciferol and calcitriol on calcium metabolism and bone turnover in Chinese postmenopausal women with vitamin D insufficiency. Acta Pharmacol Sin 33(4):490–495CrossRef

14.

Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson Hughes B (2005) Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 293:2257–2264CrossRef

15.

Binkley N, Novotny R, Krueger D, Kawahara TN, Daida YG, Gemar D, Lensmeyer GL, Hollis BW, Drezner MK (2007) J. Low vitamin D status despite abundant sun exposure. J Clin Endocrinol Metab 92:2130–2135CrossRef

16.

Holick MF, Siris ES, Binkley N, Beard MK, Khan A, Katzer J, Petruschek RA, Chen E, dePapp AE (2005) Prevalence of Vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab 90: 3215–24CrossRef

17.

Seeman E, Delmas PD (2006) Bone quality-the material and structural basis of bone strength and fragility. N Engl J Med 354:2250–2261CrossRef

18.

Ringe JD, Schacht E (2004) Prevention and therapy of osteoporosis: the roles of plain vitamin D and alfacalcidol. Rheumatol Int 24:189–197CrossRef

19.

Tsukamoto Y, Watanabe T, Nakagami T, Morishita K (2003) Effect of treatment with oral calcitriol on calcium metabolism and fasting serum 25OH-or 1,25(OH)2 vitamin D level in Japanese postmenopausal women. Endocr J 50:681–687CrossRef

20.

Gurlek A, Pittelkow MR, Kumar R (2002) Modulation of growth factor/cytokine synthesis and signalling by 1alpha,25dihydroxyvitamin D3: implications in cell growth and differentiation. Endocr Rev 23:763–786CrossRef

21.

Sibata T, Shira-Ishi A, Sato T, Masaki T, Sasaki A, Masuda Y et al (2002) Vitamin D hormone inhibits osteoclastogenesis in vivo by decreasing the pool of osteoclast precursors in bone marrow. J Bone Miner Res 17:622–629CrossRef

22.

Dobnig H (2011) A review of the health consequences of the vitamin D deficiency pandemic. J Neurol Sci 311(1–2):15–18CrossRef

23.

Clements MR, Davies M, Hayes ME, Hickey CD, Lumb GA, Mawer EB et al (1992) The role of 1,25-dihydroxyvitamin D in the mechanism of acquired vitamin D deficiency. Clin Endocrinol. Oxf 37:17–27

24.

Halloran BP, Bikle DD, Levens MJ, Castro ME, Globus RK, Holton E (1986) Chronic 1,25-dihydroxyvitamin D3 administration in the rat reduces the serum conentration of 25-hydroxyvitamin D by increasing metabolic clearance rate. J Clin Invest 78:622–628CrossRef

25.

Harwood RH, Sahota O, Gaynor K, Masud T, Hosking DJ (2004) A randomised controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after hip fracture: the Nottingham neck of femur (NoNOF) study. Age Ageing 33:45–51CrossRef

26.

Richy F, Ethgen O, Bruyere O, Reginster J-Y (2004) Efficacy of alfacalcidol and calcitriol in primary and corticosteroid-induced osteoporosis: a meta-analysis of their effects on bone mineral density and fracture rate. Osteoporos Int 15(4):301–310CrossRef

27.

Gallagher JC (2004) The effects of calcitriol on falls and fractures and physical performance tests. J Steroid Biochem Mol Biol 89-90:497–501CrossRef

28.

Schacht E, Richy F, Reginster J-Y (2005) The therapeutic effects of alfacalcidiol on bone strength, muscle metabolism and prevention of falls and fractures. J Musculoskelet Neuronal Interact 5(3):273–284PubMed

29.

Richy F, Dukas L, Schacht E (2008) Differential effects of D-hormone analogus and native vitamin D on the risk of falls: a comparative meta-analysis. Calcif Tissue Int 82:102–107CrossRef

30.

Shane E, Adesso V, Namerow PB, McMahon DJ, Lo SH, Staron RB, Zucker M, Pardi S, Maybaum S, Mancini D (2004) Alendronate or calcitriol and prevention of bone loss after cardiac transplantation. N Engl J Med 350(8):767–776CrossRef

31.

Frediani B, Allegri A, Bisohno S, Marcolongo R (1998) Effects combined treatment with calcitriol plus alendronate on bone mass and bone turnover in postmenopausal osteoporosis. Two years of continuous treatment. Clin Drug Invest 14:235–244CrossRef

32.

Hermann M, Widmann T, Colaianni G, Colucci S, Zallone A, Hermann W (2005) Increased osteoclastic activity in the presence of increased homocysteine concentrations. Clin Chem 51:2348–2353CrossRef

33.

Hubmacher D, Sabatier L, Annis DS, Mosher DF (2011) Reinhardt DP. Homocysteine modifies structural and functional properties of fibronectin and interferes with the fibronectin-fibrillin-1 interaction. Biochemistry 50:5322–5332CrossRef

34.

Calo L, Castrignano R, Davis PA, Carraro G, Pagnin E, Giannini S, Semplicini A, D’Angelo AA (2000) Role of insulin-like growth factor-I in primary osteoporosis: a correlative study. J Endocrinol Investig 23:223–227CrossRef

35.

Boonen S, Mohan S, Dequeker J, Aerssens J, Vanderschueren D, Verbeke G, Broos P, Bouillon R, Baylink DJ (1999) Down-regulation of the serum stimulatory components of the insulin-like growth factor (IGF) system (IGF-I, IGF-II, IGF binding protein (BP)-3 and IGFBP-5) in age related (type II) femoral neck osteoporosis. J Bone Miner Res 14:2150–2158CrossRef

36.

Li J, Jih D, Fu S, Mei G, Zhou J, Lei L, Yu B, Wang G (2013) Insulin -like growth factor binding protein-3 modulates osteoblast differentiation via interaction with vitamin D receptor. Biochem Biophys Res Commun 436:632–637CrossRef

Titel: Calcitriol treatment in patients with low vitamin D levels
verfasst von: Refik Tanakol
Nurdan Gül
Ayşe Kubat Üzüm
Ferihan Aral
Publikationsdatum: 01.12.2018
Verlag: Springer London
Erschienen in: Archives of Osteoporosis / Ausgabe 1/2018
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-018-0529-2

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

25.04.2024 | Hypertonie | Nachrichten

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Calcitriol treatment in patients with low vitamin D levels

Abstract

Summary

Purpose/introduction

Methods

Results

Conclusions

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Update Orthopädie und Unfallchirurgie

Springer Medizin

Abstract

Summary

Purpose/introduction

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2018

Sports participation and fracture in older Australian men

Association between polycyclic aromatic hydrocarbons and osteoporosis: data from NHANES, 2005–2014

Effect of vertebral exclusion on TBS and FRAX calculations

Correspondence between bone mineral density and intervertebral disc degeneration across age and sex

Hip and spine bone mineral density are greater in master sprinters, but not endurance runners compared with non-athletic controls

Individualized evaluation of lumbar bone mineral density in children with cerebral palsy

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Update Orthopädie und Unfallchirurgie