Morita A, Tabata T, Inoue T, Nishizawa Y, Morii H
Department of Internal Medicine, Inoue Hospital, Osaka, Japan.
Clin Nephrol. 1996 Dec;46(6):389-93.
We have studied the effect of different doses of 1 alpha-hydroxycalciferol (1 alpha [OH]D3) on bone mineral density (BMD) of 165 male hemodialysis patients (ages from 24 to 71 years) using dual X-ray absorptiometry (DXA) in a one-year follow-up study. There were no fractures in their lumbar spine participated in the study. 1 alpha (OH)D3 was administered orally at a low dose (0.25 microgram/day, n = 56, Group L) or at a higher dose (0.5 to 1.0 microgram/day, average 0.58 +/- 0.02 microgram/day, n = 65, Group H), and the absolute BMD values and the percent annual changes of BMD were compared with those who took no 1 alpha (OH)D3 (n = 44, Group N). BMD was measured three ways at the start and the end of the study; 1) lumbar spine BMD at anterior-posterior view (AP-BMD), 2) lumbar spine BMD at lateral view (Lat-BMD), and 3) 1/3 distal radius BMD. Plain spinal radiographs indicated no bone fracture before nor during the study. Although there were no detectable changes in the absolute values of BMD during the one-year period, significant differences were observed in the percent annual changes of lumbar spine BMD among the three groups. The annual changes of lumbar spine BMD among the three groups. The annual changes of AP-BMD were -0.4 +/- 0.7%, +0.1 +/- 0.6%, and +2.4 +/- 0.8% in Group N, Group L and Group H, respectively. These changes were statistically significant (p = 0.011 by one-way ANOVA). The positive effect of 1 alpha (OH)D3 on Lat-BMD was also significant (p = 0.028 by one-way ANOVA), while the treatment did not affect the change of BMD at 1/3 distal radius. There was no significant difference among the three groups in the initial or final levels of biochemical parameters including serum calcium, phosphorus, alkaline phosphatase, osteocalcin and parathyroid hormone. These results indicate, in male hemodialysis patients, that oral 1 alpha (OH)D3 treatment is effective in the prevention of lumbar spine BMD loss which is frequently observed in hemodialysis patients.
在一项为期一年的随访研究中，我们使用双能X线吸收法（DXA）研究了不同剂量的1α-羟基维生素D3（1α[OH]D3）对165例男性血液透析患者（年龄24至71岁）骨密度（BMD）的影响。参与研究的患者腰椎均未发生骨折。1α（OH）D3以低剂量（0.25微克/天，n = 56，L组）或高剂量（0.5至1.0微克/天，平均0.58±0.02微克/天，n = 65，H组）口服给药，并将BMD的绝对数值和年变化百分比与未服用1α（OH）D3的患者（n = 44，N组）进行比较。在研究开始和结束时通过三种方式测量BMD：1）前后位腰椎BMD（AP-BMD），2）侧位腰椎BMD（Lat-BMD），以及3）桡骨远端1/3处BMD。普通脊柱X线片显示在研究前和研究期间均无骨折。尽管在一年期间BMD的绝对值没有可检测到的变化，但三组之间腰椎BMD的年变化百分比存在显著差异。三组腰椎BMD的年变化情况。N组、L组和H组的AP-BMD年变化分别为-0.4±0.7%、+0.1±0.6%和+2.4±0.8%。这些变化具有统计学意义（单因素方差分析，p = 0.011）。1α（OH）D3对Lat-BMD的积极作用也具有显著性（单因素方差分析，p = 0.028），而该治疗对桡骨远端1/3处BMD的变化没有影响。三组在包括血清钙、磷、碱性磷酸酶、骨钙素和甲状旁腺激素在内的生化参数的初始或最终水平上没有显著差异。这些结果表明，在男性血液透析患者中，口服1α（OH）D3治疗可有效预防血液透析患者中经常出现的腰椎BMD丢失。
