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[1,25-二羟维生素D3对老年性骨质疏松症骨矿物质含量的影响——一项剂量探索性研究]

[The effect of 1,25(OH)2D3 on bone mineral content in senile osteoporosis--a dose-finding study].

作者信息

Shiraki M, Ito H, Orimo H

机构信息

Department of Laboratory Medicine, Tokyo Metropolitan Geriatric Hospital.

出版信息

Nihon Naibunpi Gakkai Zasshi. 1989 Nov 20;65(11):1253-63. doi: 10.1507/endocrine1927.65.11_1253.

Abstract

In order to clarify the effect of 1,25(OH)2D3 on the bone mineral content in senile osteoporosis, we examined the radial mineral density in 41 female cases of senile osteoporosis treated with 1,25(OH)2D3. The diagnostic criteria of senile osteoporosis were as follows. 1) Radial mineral density at below 0.5 g/cm2 by SPA 2) Bone dystrophy score in vertebra at over I degree 3) Presence of vertebral fracture 4) Over 60 years of age The subjects were divided into 5 groups: a control group (n = 11), a 0.25 microgram of 1,25(OH)2D3 once-a-day group (n = 5), a 0.5 microgram of 1,25(OH)2D3 once-a-day group (n = 8), a 0.25 microgram of 1,25(OH)2D3 twice-a-day group (n = 8) and a 0.25 microgram of 1,25(OH)2D3 three times-a-day group (n = 9). There was no significant difference in background data among these groups except for serum Al-P activity. The radial mineral density was measured in these 5 groups before and every 3 months after, starting the treatment by single photon absorptiometry in 1/3 distal site of radius for 1 year. No significant difference was detected in the serum levels of Ca, Pi and Al-P activity after starting the treatment among the 5 groups. The area under curve (AUC) of the radial mineral content after the treatment was calculated in each group. There was a significant dose-related increase in the AUC (p less than 0.05). However, the urinary Ca/Cr ratio was increased in the group receiving 0.75 microgram/day of 1,25(OH)2D3 The final AUC in the group receiving 0.5 microgram/day of 1,25(OH)2D3 tended to be very high compared with that in the other groups. From the above, it was suggested that 1,25(OH)2D3 might be effective for the treatment of senile osteoporosis especially at the dose of 0.5 microgram/day.

摘要

为阐明1,25(OH)₂D₃对老年骨质疏松症骨矿物质含量的影响,我们检测了41例接受1,25(OH)₂D₃治疗的老年女性骨质疏松症患者的桡骨矿物质密度。老年骨质疏松症的诊断标准如下:1) 单光子吸收法(SPA)测得桡骨矿物质密度低于0.5g/cm²;2) 椎体骨营养不良评分超过I度;3) 存在椎体骨折;4) 年龄超过60岁。研究对象分为5组:对照组(n = 11)、1,25(OH)₂D₃ 0.25微克每日一次组(n = 5)、1,25(OH)₂D₃ 0.5微克每日一次组(n = 8)、1,25(OH)₂D₃ 0.25微克每日两次组(n = 8)和1,25(OH)₂D₃ 0.25微克每日三次组(n = 9)。除血清碱性磷酸酶(Al-P)活性外,这些组之间的背景数据无显著差异。采用单光子吸收法在桡骨远端1/3处对这5组患者在治疗前及开始治疗后每3个月测量一次桡骨矿物质密度,为期1年。治疗开始后,5组患者的血清钙、磷和Al-P活性水平未检测到显著差异。计算每组治疗后桡骨矿物质含量的曲线下面积(AUC)。AUC存在显著的剂量相关性增加(p < 0.05)。然而,接受1,25(OH)₂D₃ 0.75微克/天的组尿钙/肌酐比值升高。接受1,25(OH)₂D₃ 0.5微克/天的组最终AUC与其他组相比往往非常高。综上所述,提示1,25(OH)₂D₃可能对老年骨质疏松症治疗有效,尤其是剂量为0.5微克/天时。

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