Watanabe Reiko, Inoue Daisuke
Third Department of Medicine, Teikyo University Chiba Medical Center, Japan.
Clin Calcium. 2017;27(11):1615-1622.
Vitamin D is indispensable for bone health and calcium metabolism, and decreased action of vitamin D causes various abnormalities in bone metabolism. Severe vitamin D deficiency causes osteomalacia/rickets. Even milder vitamin D insufficiency could still be harmful for bone health via secondary hyperparathyroidism and bone loss, and could also lead to increased risk of falling. Osteomalacia/rickets associated with impaired vitamin D action should be treated by either native or active vitamin D, depending on its etiology. As for osteoporosis, vitamin D repletion is important to adequate therapeutic effects of anti-resorptives. As a monotherapy, eldecalcitol, active vitamin D analogue, has been shown to increase bone mineral density and to decrease the incidence of vertebral fractures with significantly greater efficacy compared to active vitamin D.
维生素D对骨骼健康和钙代谢不可或缺,维生素D作用减弱会导致骨代谢出现各种异常。严重的维生素D缺乏会导致骨软化症/佝偻病。即使是较轻微的维生素D不足,仍可能通过继发性甲状旁腺功能亢进和骨质流失对骨骼健康有害,还可能导致跌倒风险增加。与维生素D作用受损相关的骨软化症/佝偻病应根据其病因,用天然或活性维生素D进行治疗。至于骨质疏松症,补充维生素D对于抗吸收药物的充分治疗效果很重要。作为单一疗法,活性维生素D类似物 eldecalcitol 已被证明可增加骨矿物质密度,并降低椎体骨折的发生率,与活性维生素D相比,其疗效显著更高。