Adachi J D, Bensen W G, Bianchi F, Cividino A, Pillersdorf S, Sebaldt R J, Tugwell P, Gordon M, Steele M, Webber C, Goldsmith C H
Rheumatic Disease Unit, St. Joseph's Hospital, McMaster University, Hamilton, Canada.
J Rheumatol. 1996 Jun;23(6):995-1000.
To determine the efficacy and safety of vitamin D 50,000 units/week and calcium 1,000 mg/day in the prevention of corticosteroid induced osteoporosis.
A minimized double blind, placebo controlled trial in corticosteroid treated subjects in a tertiary care university affiliated hospital. The sample was 62 subjects with polymyalgia rheumatica, temporal arteritis, asthma, vasculitis, or systemic lupus erythematosus. The primary outcome measure was the percentage change in bone mineral density (BMD) of the lumbar spine in the 2 treatment groups from baseline to 36 mo followup.
BMD of the lumbar spine in the vitamin D and calcium treated group decreased by a mean (SD) of 2.6% (4.1%) at 12 mo, 3.7% (4.5%) at 24 mo, and 2.2% (5.8%) at 36 mo. In the placebo group there was a decrease of 4.1% (4.1%) at 12 mo, 3.8% (5.6%) at 24 mo, and 1.5% (8.8%) at 36 mo. The observed differences between groups were not statistically significant. The difference at 36 mo was-0.693% (95% CI -5.34, 3.95).
Vitamin D and calcium may help prevent the early loss of bone seen in the lumbar spine as measured by densitometry of the lumbar spine. Longterm vitamin D and calcium in those undergoing extended therapy with corticosteroids does not appear to be beneficial.
确定每周50,000单位维生素D和每日1,000毫克钙预防皮质类固醇诱导的骨质疏松症的疗效和安全性。
在一所大学附属医院接受皮质类固醇治疗的受试者中进行最小化双盲、安慰剂对照试验。样本为62例患有风湿性多肌痛、颞动脉炎、哮喘、血管炎或系统性红斑狼疮的受试者。主要结局指标是两个治疗组从基线到36个月随访期间腰椎骨密度（BMD）的百分比变化。
维生素D和钙治疗组的腰椎BMD在12个月时平均（标准差）下降2.6%（4.1%），24个月时下降3.7%（4.5%），36个月时下降2.2%（5.8%）。安慰剂组在12个月时下降4.1%（4.1%），24个月时下降3.8%（5.6%），36个月时下降1.5%（8.8%）。组间观察到的差异无统计学意义。36个月时的差异为-0.693%（95%CI -5.34，3.95）。
通过腰椎骨密度测定，维生素D和钙可能有助于预防腰椎早期骨质流失。长期使用维生素D和钙对接受长期皮质类固醇治疗的患者似乎并无益处。
