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高剂量补充维生素D对多发性硬化症患者的生化骨标志物无影响——一项随机对照试验

High dose vitamin D supplementation does not affect biochemical bone markers in multiple sclerosis - a randomized controlled trial.

作者信息

Holmøy Trygve, Lindstrøm Jonas Christoffer, Eriksen Erik Fink, Steffensen Linn Hofsøy, Kampman Margitta T

机构信息

Department of Neurology, Akershus University Hospital, Lørenskog, Norway.

Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

BMC Neurol. 2017 Apr 4;17(1):67. doi: 10.1186/s12883-017-0851-0.

Abstract

BACKGROUND

People with multiple sclerosis have high risk of osteoporosis and fractures. A poor vitamin D status is a risk factor for MS, and vitamin D supplementation has been recommended both to prevent MS progression and to maintain bone health.

METHODS

We assessed the effect of 20,000 IU vitamin D weekly compared to placebo on biochemical markers of bone metabolism in 68 persons with relapsing remitting multiple sclerosis.

RESULTS

Serum levels of 25-hydroxyvitamin D more than doubled in the vitamin D group, and parathyroid hormone decreased in the vitamin D group compared to the placebo group at week 48 and week 96. There was however no effect on bone formation as measured by procollagen type I N propeptide (PINP), or on bone resorption as measured by C-terminal cross-linking telopeptide of type I collagen (CTX1). Neither PINP nor CTX1 predicted bone loss from baseline to week 96.

CONCLUSIONS

These findings corroborate the previously reported lack of effect of weekly high dose vitamin D supplementation on bone mass density in the same patients, and suggest that such vitamin D supplementation does not prevent bone loss in persons with MS who are not vitamin D deficient.

TRIAL REGISTRATION

The trial was registered at ClinicalTrials.gov on April 4 2008, registration number NCT00785473 .

摘要

背景

多发性硬化症患者患骨质疏松症和骨折的风险较高。维生素D水平低下是多发性硬化症的一个风险因素,已建议补充维生素D以预防多发性硬化症进展并维持骨骼健康。

方法

我们评估了每周20000国际单位维生素D与安慰剂相比,对68例复发缓解型多发性硬化症患者骨代谢生化标志物的影响。

结果

在第48周和第96周时,维生素D组血清25-羟维生素D水平增加了一倍多,与安慰剂组相比,维生素D组甲状旁腺激素水平降低。然而,通过I型前胶原N端前肽(PINP)测量的骨形成或通过I型胶原C端交联端肽(CTX1)测量的骨吸收均无影响。从基线到第96周,PINP和CTX1均未预测骨量丢失。

结论

这些发现证实了先前报道的每周高剂量补充维生素D对同一患者骨密度缺乏影响,并表明这种维生素D补充不能预防非维生素D缺乏的多发性硬化症患者的骨质流失。

试验注册

该试验于2008年4月4日在ClinicalTrials.gov注册,注册号为NCT00785473。

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Vitamin D supplementation guidelines.维生素D补充指南。
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