Geusens P, Vanderschueren D, Verstraeten A, Dequeker J, Devos P, Bouillon R
Division of Rheumatology, U.Z. Pellenberg, K.U. Leuven, Belgium.
Calcif Tissue Int. 1991 Sep;49(3):168-73. doi: 10.1007/BF02556112.
We investigated the effect of short-term, 1,25-dihydroxyvitamin D3 therapy (4 micrograms/day for 4 days) on calcium metabolism in 27 postmenopausal women (11 cases with osteoporosis and 16 cases with osteoarthritis). Bone mass at the axial and appendicular skeleton was higher in osteoarthritis than in osteoporosis. Initial values of calcium metabolism were similar. Osteoporotic and osteoarthritic patients responded with a similar significant increase in serum osteocalcin (+61% and +54%, respectively), fasting urinary calcium excretion (+178% and +124%, respectively) and 24 hour calcium excretion (+148% and +142%, respectively). Parathyroid hormone (PTH) levels decreased significantly in both groups (-30% and -18%, respectively). Osteoclastic bone resorption, evaluated by urinary hydroxyproline excretion, was not stimulated in either group. We conclude that in osteoporosis and also in osteoarthritis (1) 1,25-dihydroxy-vitamin D3 (1,25(OH)2D3) stimulation of osteoblast function is similar in production of osteocalcin; (2) the vitamin D target tissues react adequately to 1,25(OH)2D3 stimulation; (3) short-term high dose of 1,25(OH)2D3 does not stimulate bone resorption; and (4) the differences in bone mass between osteoarthritis and osteoporosis are not related to an alteration of the responsiveness to stimulation by 1,25 (OH)2D3.
我们研究了短期1,25 - 二羟维生素D3治疗（4微克/天，共4天）对27名绝经后女性（11例骨质疏松症患者和16例骨关节炎患者）钙代谢的影响。轴骨和附属骨骼的骨量在骨关节炎患者中高于骨质疏松症患者。钙代谢的初始值相似。骨质疏松症和骨关节炎患者血清骨钙素均显著增加（分别增加61%和54%），空腹尿钙排泄量显著增加（分别增加178%和124%），24小时钙排泄量显著增加（分别增加148%和142%）。两组甲状旁腺激素（PTH）水平均显著下降（分别下降30%和18%）。通过尿羟脯氨酸排泄评估的破骨细胞骨吸收在两组中均未受到刺激。我们得出结论，在骨质疏松症和骨关节炎中：（1）1,25 - 二羟维生素D3（1,25(OH)2D3）对成骨细胞功能的刺激在骨钙素产生方面相似；（2）维生素D靶组织对1,25(OH)2D3刺激反应充分；（3）短期高剂量的1,25(OH)2D3不会刺激骨吸收；（4）骨关节炎和骨质疏松症之间的骨量差异与对1,25(OH)2D3刺激的反应性改变无关。
