Zhang Dongdong, Seo Da Hea, Choi Han Seok, Park Hye Sun, Chung Yoon Sok, Lim Sung Kil
Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China.
Endocrinol Metab (Seoul). 2017 Dec;32(4):451-459. doi: 10.3803/EnM.2017.32.4.451.
Vitamin D deficiency remains common in all age groups and affects skeletal and non-skeletal health. Fibroblast growth factor 23 is a bone-derived hormone that regulates phosphate and 1,25-dihydroxyvitamin D homeostasis as a counter regulatory factor. 1,25-Dihydroxyvitamin D stimulates fibroblast growth factor 23 synthesis in bone, while fibroblast growth factor 23 suppresses 1,25-dihydroxyvitamin D production in the kidney. The aim of this study was to evaluate the effects of vitamin D₃ intramuscular injection therapy on serum fibroblast growth factor 23 concentrations, and several other parameters associated with bone metabolism such as sclerostin, dickkopf-1, and parathyroid hormone.
A total of 34 subjects with vitamin D deficiency (defined by serum 25-hydroxyvitamin D levels below 20 ng/mL) were randomly assigned to either the vitamin D injection group (200,000 units) or placebo treatment group. Serum calcium, phosphate, urine calcium/creatinine, serum 25-hydroxyvitamin D, fibroblast growth factor 23, sclerostin, parathyroid hormone, and dickkopf-1 levels were serially measured after treatment.
Comparing the vitamin D injection group with the placebo group, no significant changes were observed in serum fibroblast growth factor 23, parathyroid hormone, or dickkopf-1 levels. Serum sclerostin concentrations transiently increased at week 4 in the vitamin D group. However, these elevated levels declined later and there were no statistically significant differences as compared with baseline levels.
Serum fibroblast factor 23, sclerostin, parathyroid hormone, and dickkopf-1 levels were not affected significantly by single intramuscular injection of vitamin D₃.
维生素D缺乏在所有年龄组中都很常见,并影响骨骼和非骨骼健康。成纤维细胞生长因子23是一种骨源性激素,作为一种反调节因子调节磷酸盐和1,25-二羟基维生素D的稳态。1,25-二羟基维生素D刺激骨中成纤维细胞生长因子23的合成,而成纤维细胞生长因子23抑制肾脏中1,25-二羟基维生素D的产生。本研究的目的是评估维生素D₃肌肉注射疗法对血清成纤维细胞生长因子23浓度以及其他一些与骨代谢相关参数(如骨硬化蛋白、Dickkopf-1和甲状旁腺激素)的影响。
共有34名维生素D缺乏(定义为血清25-羟基维生素D水平低于20 ng/mL)的受试者被随机分配到维生素D注射组(200,000单位)或安慰剂治疗组。治疗后连续测量血清钙、磷、尿钙/肌酐、血清25-羟基维生素D、成纤维细胞生长因子23、骨硬化蛋白、甲状旁腺激素和Dickkopf-1水平。
将维生素D注射组与安慰剂组进行比较,血清成纤维细胞生长因子23、甲状旁腺激素或Dickkopf-1水平未观察到显著变化。维生素D组在第4周时血清骨硬化蛋白浓度短暂升高。然而,这些升高的水平随后下降,与基线水平相比无统计学显著差异。
单次肌肉注射维生素D₃对血清成纤维细胞因子23、骨硬化蛋白、甲状旁腺激素和Dickkopf-1水平没有显著影响。