Viljakainen Heli T, Väisänen Milja, Kemi Virpi, Rikkonen Toni, Kröger Heikki, Laitinen E Kalevi A, Rita Hannu, Lamberg-Allardt Christel
Calcium Research Unit, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland.
J Bone Miner Res. 2009 Feb;24(2):346-52. doi: 10.1359/jbmr.081009.
Vitamin D is suggested to have a role in the coupling of bone resorption and formation. Compared with women, men are believed to have more stable bone remodeling, and thus, are considered less susceptible to the seasonal variation of calcitropic hormones. We examined whether seasonal variation exists in calcitropic hormones, bone remodeling markers, and BMD in healthy men. Furthermore, we determined which vitamin D intake is required to prevent this variation. Subjects (N = 48) were healthy white men 21-49 yr of age from the Helsinki area with a mean habitual dietary intake of vitamin D of 6.6 +/- 5.1 (SD) microg/d. This was a 6-mo double-blinded vitamin D intervention study, in which subjects were allocated to three groups of 20 microg (800 IU), 10 microg (400 IU), or placebo. Fasting blood samplings were collected six times for analyses of serum (S-)25(OH)D, iPTH, bone-specific alkaline phosphatase (BALP), and TRACP. Radial volumetric BMD (vBMD) was measured at the beginning and end of the study with pQCT. Wintertime variation was noted in S-25(OH)D, S-PTH, and S-TRACP (p < 0.001, p = 0.012, and p < 0.05, respectively) but not in S-BALP or vBMD in the placebo group. Supplementation inhibited the winter elevation of PTH (p = 0.035), decreased the S-BALP concentration (p < 0.05), but benefited cortical BMD (p = 0.09) only slightly. Healthy men are exposed to wintertime decrease in vitamin D status that impacts PTH concentration. Vitamin D supplementation improved vitamin D status and inhibited the winter elevation of PTH and also decreased BALP concentration. The ratio of TRACP to BALP shows the coupling of bone remodeling in a robust way. A stable ratio was observed among those retaining a stable PTH throughout the study. A daily intake of vitamin D in the range of 17.5-20 microg (700-800 IU) seems to be required to prevent winter seasonal increases in PTH and maintain stable bone turnover in young, healthy white men.
维生素D被认为在骨吸收与骨形成的偶联过程中发挥作用。与女性相比,男性的骨重塑被认为更稳定,因此,被认为较不易受促钙激素季节性变化的影响。我们研究了健康男性的促钙激素、骨重塑标志物和骨密度是否存在季节性变化。此外,我们确定了预防这种变化所需的维生素D摄入量。研究对象(N = 48)为来自赫尔辛基地区的21 - 49岁健康白人男性,其维生素D的平均习惯性膳食摄入量为6.6±5.1(标准差)μg/d。这是一项为期6个月的双盲维生素D干预研究,研究对象被分为三组,分别摄入20μg(800 IU)、10μg(400 IU)维生素D或安慰剂。空腹采血6次,用于分析血清(S -)25(OH)D、iPTH、骨特异性碱性磷酸酶(BALP)和TRACP。在研究开始和结束时用pQCT测量桡骨体积骨密度(vBMD)。安慰剂组中,S - 25(OH)D、S - PTH和S - TRACP出现冬季变化(分别为p < 0.001、p = 0.012和p < 0.05),但S - BALP或vBMD未出现冬季变化。补充维生素D可抑制冬季PTH升高(p = 0.035),降低S - BALP浓度(p < 0.05),但仅对皮质骨骨密度有轻微益处(p = 0.09)健康男性在冬季维生素D水平会下降,这会影响PTH浓度。补充维生素D可改善维生素D水平,抑制冬季PTH升高,并降低BALP浓度。TRACP与BALP的比值能有力地显示骨重塑的偶联情况。在整个研究过程中PTH保持稳定的人群中观察到了稳定的比值。对于年轻、健康的白人男性,每日摄入17.5 - 20μg(700 - 800 IU)维生素D似乎是预防冬季PTH季节性升高并维持稳定骨转换所必需的。