Hartwell D, Hassager C, Overgaard K, Riis B J, Pødenphant J R, Christiansen C
Department of Clinical Chemistry, Glostrup Hospital, University of Copenhagen, Denmark.
Acta Endocrinol (Copenh). 1990 Jun;122(6):715-21. doi: 10.1530/acta.0.1220715.
We assessed the effects of a continuous oral combination of estradiol and norethisterone acetate, nandrolone decanoate, or salmon calcitonin on the vitamin D endocrine system. One hundred and nineteen postmenopausal women, aged 55-75 years, with at least one osteoporotic fracture, were randomly allocated to one year of treatment with estradiol and norethisterone acetate, nandrolone decanoate, or calcitonin, all drugs with a beneficial effect on bone. All three trials were double-blind and placebo-controlled; 104 women (87%) completed the study. We measured the total serum concentration of 1,25-dihydroxyvitamin D (1,25(OH)2D) and vitamin D-binding protein, and estimated the free 1,25(OH)2D index and the "24-hydroxylase activity" initially, and at 6 and 12 months. Furthermore, the 24-h urinary excretions of calcium, phosphate, and adenosine 3'-5'-cyclic monophosphate were assessed initially and at 12 months. The serum concentration of vitamin D-binding protein and 1,25(OH)2D increased transiently during estradiol and norethisterone acetate treatment and vitamin D-binding protein decreased transiently during nandrolone decanoate treatment. None of the other parameters were significantly affected by any of the three treatments. The risk of type II errors was below 10 per cent for all vitamin D measurements. We conclude that the vitamin D metabolites are unlikely to be of major importance for the mechanism by which these drugs exert their positive skeletal effects.
我们评估了雌二醇与醋酸炔诺酮、癸酸诺龙或鲑鱼降钙素持续口服联合用药对维生素D内分泌系统的影响。119名年龄在55 - 75岁之间、至少发生过一次骨质疏松性骨折的绝经后女性被随机分配接受为期一年的雌二醇与醋酸炔诺酮、癸酸诺龙或降钙素治疗，所有这些药物对骨骼均有有益作用。所有三项试验均为双盲且安慰剂对照；104名女性（87%）完成了研究。我们最初以及在6个月和12个月时测量了血清1,25 - 二羟维生素D（1,25(OH)2D）和维生素D结合蛋白的总浓度，并估算了游离1,25(OH)2D指数和“24 - 羟化酶活性”。此外，最初以及在12个月时评估了24小时尿钙、磷和腺苷3'-5'-环磷酸的排泄量。在雌二醇与醋酸炔诺酮治疗期间，维生素D结合蛋白和1,25(OH)2D的血清浓度短暂升高，而在癸酸诺龙治疗期间，维生素D结合蛋白短暂降低。这三种治疗中的任何一种对其他参数均无显著影响。所有维生素D测量的II类错误风险均低于10%。我们得出结论，维生素D代谢产物对于这些药物发挥其积极骨骼效应的机制不太可能具有重要意义。
