Department of Endocrinology and Metabolism, Istanbul University, Istanbul Faculty of Medicine, Çapa, P.O. Box: 40, 34390, Istanbul, Turkey.
Arch Osteoporos. 2018 Oct 23;13(1):114. doi: 10.1007/s11657-018-0529-2.
The aim of the the study is to compare the effects of cholecalciferol and calcitriol on bone mineral metabolism in women with vitamin D deficiency. Calcitriol was associated with a significant increase in bone mineral density at the lumbar spine in patients with low vitamin D levels.
PURPOSE/INTRODUCTION: Active vitamin D analogs may have larger impact in decreasing bone loss and fracture rate compared to cholecalciferol in osteoporosis. However, their effects in the treatment of vitamin D deficiency compared to cholecalciferol are not clear. The aim of the present study is to compare the effects of cholecalciferol and calcitriol on bone mineral metabolism and bone mineral density in pre- and postmenopausal women with vitamin D deficiency.
This was a 6-month prospective, open-label, controlled clinical trial. Eligible 120 participants were pre- and postmenopausal women diagnosed with vitamin D deficiency. Forty-three subjects (group 1) received 1000 IU of cholecalciferol and 1 g of calcium daily. The other 77 subjects (group 2) received 0.5 μg calcitriol in addition to 400 IU of cholecalciferol and 1 g of calcium daily.
Oral vitamin D supplementation did not increase bone mineral density after 6 months of intervention in group 1. On the other hand, bone mineral density at the lumbar spine increased from 0.809 ± 0.172 to 0.848 ± 0.161 g/cm in group 2 patients (p < 0.017 vs baseline).
Oral daily calcitriol was associated with a significant increase in bone mineral density at the lumbar spine in patients with low vitamin D, elevated PTH, and osteoporosis.
目的/引言：与胆钙化醇相比，活性维生素 D 类似物在降低骨质疏松症患者的骨丢失和骨折率方面可能具有更大的影响。然而，它们在维生素 D 缺乏症治疗方面的效果与胆钙化醇相比尚不清楚。本研究旨在比较胆钙化醇和骨化三醇对维生素 D 缺乏的绝经前和绝经后妇女的骨矿物质代谢和骨密度的影响。
这是一项为期 6 个月的前瞻性、开放标签、对照临床试验。符合条件的 120 名参与者为被诊断为维生素 D 缺乏的绝经前和绝经后妇女。43 名受试者（第 1 组）每天服用 1000IU 胆钙化醇和 1g 钙。另外 77 名受试者（第 2 组）每天除了服用 400IU 胆钙化醇和 1g 钙外，还服用 0.5μg 骨化三醇。
第 1 组在干预 6 个月后，口服维生素 D 补充剂并未增加骨密度。另一方面，第 2 组患者的腰椎骨密度从 0.809±0.172 增加到 0.848±0.161g/cm（p<0.017 与基线相比）。
在维生素 D、甲状旁腺激素升高和骨质疏松的低水平患者中，口服每日骨化三醇与腰椎骨密度的显著增加相关。
