Calcitriol treatment in patients with low vitamin D levels
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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.
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/cm2 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.
KeywordsCalcitriol Vitamin D deficiency Osteoporosis Cholecalciferol Bone mineral density
Refik Tanakol declares no competing financial interest and certifies that no funding has been received for the conduct of this study and/or preparation of this manuscript.
Nurdan Gül declares no competing financial interest and certifies that no funding has been received for the conduct of this study and/or preparation of this manuscript.
Ayşe Kubat Üzüm declares no competing financial interest and certifies that no funding has been received for the conduct of this study and/or preparation of this manuscript.
Ferihan Aral declares no competing financial interest and certifies that no funding has been received for the conduct of this study and/or preparation of this manuscript.
Compliance with ethical standards
This study was conducted in full compliance with the principles of the Declaration of Helsinki. Ethical approval was obtained from Ethics Committee of Istanbul Faculty of Medicine (Dean’s approval and Ethics Committee ref. No. 467 70954-700-2017-551) . Written informed consent for participation was obtained from participants or, where participants are children, a parent or guardian.
Conflict of interest
- 3.Chapuy MC, Pamphile R, Paris E, Kempf C, Schlichting M, Arnaud S, Garnero P, Garnero P, Meunier PJ (2002) Combined calcium and vitamin D3 supplementation in elderly women: confirmation of reversal of secondary hyperparathyroidism and hip fracture risk: the Decalyos II study. Osteoporos Int 13(3):257–264CrossRefGoogle Scholar
- 4.Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, Chesnut CH, Brown J, Eriksen EF, Hoseyni MS, Axelrod DW, Miller PD (1999) Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis. JAMA 282(14):1344–1352CrossRefGoogle Scholar
- 5.Chesnut CH, Skag A, Christiansen C, Recker R, Stakkestad JA, Hoiseth A, Felsenberg D, Huss H, Gilbride J, Schimmer RC, Delmas PD, and for the oral ibandronate osteoporosis vertebral fracture trial in North America and Europe (Bone) (2004) Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res 19(8):1241–1249CrossRefGoogle Scholar
- 6.Meunier PJ, Slosman DO, Delmas PD, Sebert JL, Brandi ML, Albanese C, Lorenc R, Pors-Nielsen S, De Vernejoul MC, Roces A, Reginster JY (2002) Strontium ranelate: dose dependent effects in established postmenopausal vertebral osteoporosis- a 2-year randomized placebo controlled trial. J Clin Endocrinol Metab 87:2060–2066PubMedGoogle Scholar
- 16.Holick MF, Siris ES, Binkley N, Beard MK, Khan A, Katzer J, Petruschek RA, Chen E, dePapp AE (2005) Prevalence of Vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab 90: 3215–24Google Scholar
- 23.Clements MR, Davies M, Hayes ME, Hickey CD, Lumb GA, Mawer EB et al (1992) The role of 1,25-dihydroxyvitamin D in the mechanism of acquired vitamin D deficiency. Clin Endocrinol. Oxf 37:17–27Google Scholar
- 35.Boonen S, Mohan S, Dequeker J, Aerssens J, Vanderschueren D, Verbeke G, Broos P, Bouillon R, Baylink DJ (1999) Down-regulation of the serum stimulatory components of the insulin-like growth factor (IGF) system (IGF-I, IGF-II, IGF binding protein (BP)-3 and IGFBP-5) in age related (type II) femoral neck osteoporosis. J Bone Miner Res 14:2150–2158CrossRefGoogle Scholar