Lems W F, Jacobs J W, Van Rijn H J, Bijlsma J W
Dept. of Rheumatology, University Hospital of Utrecht, The Netherlands.
Clin Rheumatol. 1995 Jul;14(4):420-4. doi: 10.1007/BF02207675.
The effect of low dose prednisone on calcium and bone metabolism was evaluated in 8 healthy, young, male volunteers. Sodium and calcium intake were kept stable during the whole study period of 7 weeks. Week 0 was the baseline period; during week 1, 3 and 5 prednisone (10 mg/day) was given, during week 3 together with 500 mg elementary calcium and during week 5 with 4000 IU vitamin D on alternate days. During week 2, 4 and 6 no medication was given. No changes occurred in fasting urinary excretion of calcium or hydroxyproline, nor in serum levels of alkaline phosphatase, 25-Vitamin D, PTH, creatinine and inorganic phosphorus. A rapid decrease of serum osteocalcin during prednisone intake was found (p<0.01). This dip also occurred during prednisone and vitamin D treatment, but did not occur when calcium was added to prednisone, although the baseline value was lower at the start of combined treatment with prednisone and calcium. Serum calcium decreased during prednisone (p<0.05), but when prednisone was given together with calcium, an increase of serum calcium was found (p< 0.05). It is concluded that 10 mg prednisone/day decreases bone formation, as shown by its effect on osteocalcin, while no influence is seen on bone resorption. Thus, prednisone, even when used in low doses, influences bone metabolism by uncoupling bone formation (decreased) and bone resorption (unchanged). These data suggest that the Cs-associated decrease in serum osteocalcin and in serum calcium does not occur during calcium suppletion.
在8名健康、年轻的男性志愿者中评估了低剂量泼尼松对钙和骨代谢的影响。在为期7周的整个研究期间，钠和钙的摄入量保持稳定。第0周为基线期；在第1周、第3周和第5周给予泼尼松（10毫克/天），在第3周同时给予500毫克元素钙，在第5周隔天给予4000国际单位维生素D。在第2周、第4周和第6周未给药。空腹尿钙或羟脯氨酸排泄量、血清碱性磷酸酶、25-维生素D、甲状旁腺激素、肌酐和无机磷水平均未发生变化。发现服用泼尼松期间血清骨钙素迅速下降（p<0.01）。这种下降在泼尼松和维生素D治疗期间也出现，但在泼尼松中添加钙时未出现，尽管在泼尼松和钙联合治疗开始时基线值较低。服用泼尼松期间血清钙下降（p<0.05），但当泼尼松与钙一起给药时，血清钙升高（p<0.05）。结论是，每天10毫克泼尼松可降低骨形成，这从其对骨钙素的影响可以看出，而对骨吸收没有影响。因此，泼尼松即使以低剂量使用，也会通过使骨形成（降低）和骨吸收（不变）解偶联来影响骨代谢。这些数据表明，在补钙期间不会出现与环孢素相关的血清骨钙素和血清钙下降。
