Stefíková K, Chylová K, Krivosíková Z, Spustová V, Dzúrik R
VVZ Slovenskej zdravotníckej univerzity-Ustav preventívnej a klinickej medicíny, Bratislava, Slovenská republika.
Vnitr Lek. 2004 Apr;50(4):286-90.
Vitamin D deficiency is not possible to correct with the nutritional vitamin D doses in postmenopausal women with decreased bone mineral density. The aim of study was to evaluated the effectivity and safety of 15,000 IU/week vitamin D administrated in 52 postmenopausal women with osteopenia or osteoporosis. Patients were divided into two groups. Treated group was supplemented by calcium 0.5 g/d and 25-hydroxycholecalciferol 15,000 IU/week and control group was supplemented by calcium and placebo for two months. Plasma calcium concentration did not change in the vitamin D treated group while it decreased (p < 0.001) in the control group. Neither calciuria nor fractional excretion of calcium changed during the treatment period. Plasma inorganic phosphate concentration did not change in any group, but urinary inorganic phosphate excretion increased in the vitamin D treated group (p < 0.001). The starting 25-hydroxycholecalciferol plasma concentrations were almost at the deficiency range in both groups. The 25-hydroxycholecalciferol plasma concentration increased substantially (p < 0.001) in the treated group, but it remained at the starting level in control group during the treatment period. Similar plasma concentration increase (p < 0.001) was apparent also in 1.25-dihydroxycholecalciferol. Plasma intact parathormone concentration did not change in the vitamin D treated patients, while it increased (p < 0.01) in the control group. None of the vitamin D treated women suffered from hypercalcemia and mild hypercalciuria was observed in one patient. In conclusion, the study presents an evidence on the effectiveness and safety of 15,000 IU/week 25-hydroxycholecalciferol dosage schedule.
对于骨矿物质密度降低的绝经后女性，营养剂量的维生素D无法纠正维生素D缺乏。本研究的目的是评估每周给予15,000 IU维生素D对52例患有骨质减少或骨质疏松的绝经后女性的有效性和安全性。患者分为两组。治疗组每天补充0.5 g钙和每周15,000 IU 25-羟胆钙化醇，对照组补充钙和安慰剂，为期两个月。维生素D治疗组的血浆钙浓度没有变化，而对照组的血浆钙浓度下降（p < 0.001）。治疗期间，尿钙排泄量和钙分数排泄率均未改变。任何一组的血浆无机磷酸盐浓度均未改变，但维生素D治疗组的尿无机磷酸盐排泄量增加（p < 0.001）。两组开始时的25-羟胆钙化醇血浆浓度几乎都处于缺乏范围。治疗组的25-羟胆钙化醇血浆浓度大幅升高（p < 0.001），但对照组在治疗期间保持在起始水平。1,25-二羟胆钙化醇的血浆浓度也有类似的升高（p < 0.001）。维生素D治疗的患者血浆完整甲状旁腺激素浓度没有变化，而对照组则升高（p < 0.01）。接受维生素D治疗的女性均未出现高钙血症，仅1例患者出现轻度高钙尿症。总之，该研究提供了每周15,000 IU 25-羟胆钙化醇给药方案有效性和安全性的证据。
