Relationship between the effect of eldecalcitol and serum 25(OH)D level
Relationship between the effect of eldecalcitol and serum 25(OH)D level
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DOI：
10.1016/j.jsbmb.2013.11.005
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发表时间：
2014-10-01
影响因子：
4.1
通讯作者：
Matsumoto, Toshio
中科院分区：
文献类型：
--
作者：
Takano, Toshiyuki;Kondo, Satoshi;Matsumoto, Toshio
在以前的研究中，我们证明，无论血清25-羟基维生素D（25（OH）D）水平如何，12个月的0.75 μ g/天艾地骨化醇治疗均可增加骨质疏松患者的骨密度，在一项为期3年的随机双盲临床试验中，与阿法骨化醇相比，艾地骨化醇可显著降低椎骨和手腕骨折的发生率。然而，目前尚不清楚艾地骨化醇降低骨折风险是否受血清25（OH）D的影响。在骨折预防试验中，基线时25（OH）D水平低的患者补充400 IU/天天然维生素D3。在目前的研究中，根据治疗开始后6个月血清25（OH）D水平的三分位数对该试验的患者进行分组。在所有三分位数中，艾地骨化醇对腰椎和髋部BMD的增加均显著高于阿法骨化醇。除了低三分位数的椎骨骨折外，艾地骨化醇治疗组的每个三分位数的椎骨骨折和椎体骨折的发生率倾向于低于阿法骨化醇治疗组的相应三分位数。我们还调查了未补充维生素D的患者，艾地骨化醇治疗是否影响血清25（OH）D、血清1，25（OH）2D和甲状旁腺激素水平。艾地骨化醇治疗后，血清1，25（OH）2D浓度降低约50%，而血清甲状旁腺激素和25（OH）D水平不受影响。本研究的主要发现是，艾地骨化醇不影响血清25（OH）D水平，与阿法骨化醇相比，无论血清25（OH）D水平如何，在血清25（OH）D浓度等于或高于20 ng/mL的范围内，艾地骨化醇均能降低骨质疏松性骨折的发生率并增加BMD。艾地骨化醇是否对维生素D缺乏的血清25（OH）D水平同样有效仍有待澄清。(C)2013作者由爱思唯尔有限公司发布。保留所有权利。
In previous studies, we demonstrated that 12-month treatment with 0.75 mu g/day eldecalcitol increased bone mineral density in osteoporotic patients regardless of serum 25-hydroxyvitamin D (25(OH)D) level, and in a 3-year randomized double-blind clinical trial, eldecalcitol significantly reduced the incidences of vertebral and wrist fractures compared to alfacalcidol. However, it remains unclear whether the fracture risk reduction by eldecalcitol is affected by serum 25(OH)D. In the fracture prevention trial, patients with low 25(OH)D level at baseline were supplemented with 400 IU/day native vitamin D3. In the current study, patients from that trial were divided according to the tertiles of serum 25(OH)D level at 6 months after treatment initiation. The increases in lumbar and hip BMD by eldecalcitol were significantly higher in all tertiles than those by alfacalcidol. The incidences of vertebral and osteoporotic fractures tended to be lower in each tertile of the eldecalcitol-treated group than in the corresponding tertile of the alfacalcidol-treated group, with the exception of vertebral fractures in the low tertile. We also investigated whether eldecalcitol treatment affected levels of serum 25(OH)D, serum 1,25(OH)2D, and parathyroid hormone in patients without vitamin D supplementation. With eldecalcitol treatment, serum 1,25(OH)2D concentration was reduced by approximately 50%, whereas serum levels of parathyroid hormone and 25(OH)D were not affected. The major findings of the present study were that eldecalcitol did not affect serum 25(OH)D levels, and that it reduced the incidence of osteoporotic fractures and increased BMD in comparison with alfacalcidol regardless of serum 25(OH)D level within the range of serum 25(OH)D concentrations at or higher than 20 ng/mL. Whether eldecalcitol is similarly effective at vitamin D deficient serum 25(OH)D levels remains to be clarified.This article is part of a Special Issue entitled 'Vitamin D Workshop'. (C) 2013 The Authors. Published by Elsevier Ltd. All rights reserved.