Inoue Daisuke
Third Department of Medicine, Teikyo University Chiba Medical Center.
Nihon Rinsho. 2009 May;67(5):967-74.
Vitamin D and calcium are indispensable for the maintenance of bone mass and integrity. Active vitamin D3 has been most widely used in Japan for the treatment of osteoporosis. These drugs mildly increase bone mineral density, but it has little consistent effects on bone metabolic markers. Although weak, there is also some clinical evidence for their efficacy as a fracture-preventing drug. Recent reports suggest that vitamin D3 not only enhances intestinal calcium absorption but may also improve neuromuscular function to reduce the number of falls, thereby contributing to fracture prevention. Besides such extraskeletal effects, vitamin D analogues may also have direct bone anabolic effects, preventing fractures even under native vitamin D and calcium supplement.
维生素D和钙对于维持骨量和骨骼完整性不可或缺。活性维生素D3在日本已被最广泛地用于治疗骨质疏松症。这些药物可轻度增加骨矿物质密度,但对骨代谢标志物的作用缺乏一致性。尽管作用较弱,但也有一些临床证据表明它们作为预防骨折药物的有效性。最近的报告表明,维生素D3不仅能增强肠道对钙的吸收,还可能改善神经肌肉功能以减少跌倒次数,从而有助于预防骨折。除了这种骨骼外效应,维生素D类似物可能还具有直接的骨合成代谢作用,即使在补充天然维生素D和钙的情况下也能预防骨折。