Aloia John F, Talwar Sonia Arunabh, Pollack Simcha, Yeh James
Department of Medicine, Bone Mineral Research Center, Winthrop University Hospital, Mineola, NY 11501, USA.
Arch Intern Med. 2005 Jul 25;165(14):1618-23. doi: 10.1001/archinte.165.14.1618.
We conducted a randomized, placebo-controlled, double-blind trial to test the hypothesis that vitamin D(3) supplementation would prevent bone loss in calcium-replete, African American postmenopausal women.
Two hundred eight healthy black postmenopausal women, 50 to 75 years of age, were assigned to receive either placebo or 20 microg/d (800 IU) of vitamin D(3). Calcium supplements were provided to ensure a total calcium intake of 1200 to 1500 mg/d. After 2 years, the vitamin D(3) dose was increased to 50 microg/d (2000 IU) in the active group, and the study continued for an additional year. Bone mineral density (BMD) was measured every 6 months. Markers of bone turnover, vitamin D metabolites, and parathyroid hormone (PTH) levels were measured in serum.
There were no significant differences in BMD between the active and control groups throughout the study. There was also no relationship between serum 25-hydroxyvitamin D levels attained and rates of bone loss. There was an increase in BMD of the total body, hip, and radius at 1 year in both groups. Over the 3 years, BMD declined at these sites by 0.26% to 0.55% per year. The BMD of the lumbar spine increased slightly in the placebo and active groups. There were no persistent changes in serum PTH levels or the markers of bone turnover, although there was a transient decline in PTH in both groups at 3 months. No significant adverse events were attributed to vitamin D supplementation.
There was no observed effect of vitamin D(3) supplementation on bone loss or bone turnover markers in calcium-replete, postmenopausal African American women. Further studies are needed to determine if these findings are applicable to women of other ethnic groups.
我们进行了一项随机、安慰剂对照、双盲试验，以检验补充维生素D(3)可预防钙充足的非裔美国绝经后女性骨质流失这一假设。
208名年龄在50至75岁的健康黑人绝经后女性被分配接受安慰剂或20微克/天（800国际单位）的维生素D(3)。提供钙补充剂以确保每日总钙摄入量为1200至1500毫克。2年后，活性组的维生素D(3)剂量增加至50微克/天（2000国际单位），研究再持续一年。每6个月测量一次骨矿物质密度（BMD）。检测血清中的骨转换标志物、维生素D代谢产物和甲状旁腺激素（PTH）水平。
在整个研究过程中，活性组和对照组之间的BMD没有显著差异。血清25-羟基维生素D水平与骨质流失率之间也没有关系。两组在1年时全身、髋部和桡骨的BMD均有所增加。在3年中，这些部位的BMD每年下降0.26%至0.55%。安慰剂组和活性组腰椎的BMD略有增加。血清PTH水平或骨转换标志物没有持续变化，尽管两组在3个月时PTH有短暂下降。没有明显的不良事件归因于维生素D补充。
在钙充足的绝经后非裔美国女性中，未观察到补充维生素D(3)对骨质流失或骨转换标志物有影响。需要进一步研究以确定这些发现是否适用于其他种族的女性。
