1,25-Dihydroxyvitamin D3: short- and long-term effects on bone and calcium metabolism in patients with postmenopausal osteoporosis. (original) (raw)

• Journal List
• Proc Natl Acad Sci U S A
• v.79(10); 1982 May
• PMC346408

Proc Natl Acad Sci U S A. 1982 May; 79(10): 3325–3329.

Abstract

We evaluated the effects of therapy with a small dose (0.5 microgram/day) of 1,25-dihydroxyvitamin D3 in 12 previously untreated patients with postmenopausal osteoporosis. Combined radiocalcium kinetic and balance studies showed that at base line, net calcium absorption (mean +/- SEM) was low (7 +/- 3%), calcium balance was negative (-59 +/- 22 mg/day), and bone resorption rate (297 +/- 40 mg/day) exceeded bone formation rate (239 +/- 36 mg/day). After short-term therapy (6-8 months), calcium absorption was normal (27 +/- 3%, P less than 0.001 for difference from base line), calcium balance had improved (+2 +/- 26 mg/day, P less than 0.05), and bone resorption rate (195 +/- 35 mg/day, P less than 0.01) had decreased more than bone formation rate (197 +/- 26 mg/day, NS). Compared with base-line values, after long-term therapy (2 years) the increased level of calcium absorption was maintained (27 +/- 3%, P less than 0.001), but calcium retention declined to a level intermediate (-27 +/- 24 mg/day, NS) between base-line and short-term treatment values, and both bone resorption rate (294 +/- 33 mg/day, NS) and bone formation rate (267 +/- 34 mg/day, NS) increased. Urinary hydroxyproline excretion was lower than before treatment (26.3 +/-2.0 mg/day) after both short-term (21.1 +/- 1.6 mg/day, P less than 0.001) and long-term (22.0 +/- 1.8 mg/day, P less than 0.01) treatments. Trabecular bone volume was 11.3 +/- 1.0% at base line and increased to 16.0 +/- 1.2% (P less than 0.01) after long-term treatment. By contrast, the eight patients studied before and after 6-8 months of placebo treatment had no significant change in any variable.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (964K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

• Riggs BL, Kelly PJ, Kinney WR, Scholz DA, Bianco AJ., Jr Calcium deficiency and osteoporosis. Observations in one hundred and sixty-six patients and critical review of the literature. J Bone Joint Surg Am. 1967 Jul;49(5):915–924. [PubMed] [Google Scholar]
• Bullamore JR, Wilkinson R, Gallagher JC, Nordin BE, Marshall DH. Effect of age on calcium absorption. Lancet. 1970 Sep 12;2(7672):535–537. [PubMed] [Google Scholar]
• CANIGGIA A, GENNARI C, BIANCHI V, GUIDERI R. Intestinal absorption of 45Ca in senile osteoporosis. Acta Med Scand. 1963 May;173:613–617. [PubMed] [Google Scholar]
• Gallagher JC, Aaron J, Horsman A, Marshall DH, Wilkinson R, Nordin BE. The crush fracture syndrome in postmenopausal women. Clin Endocrinol Metab. 1973 Jul;2(2):293–315. [PubMed] [Google Scholar]
• Szymendera J, Heaney RP, Saville PD. Intestinal calcium absorption: concurrent use of oral and intravenous tracers and calculation by the inverse convolution method. J Lab Clin Med. 1972 Apr;79(4):570–578. [PubMed] [Google Scholar]
• Gallagher JC, Riggs BL, Eisman J, Hamstra A, Arnaud SB, DeLuca HF. Intestinal calcium absorption and serum vitamin D metabolites in normal subjects and osteoporotic patients: effect of age and dietary calcium. J Clin Invest. 1979 Sep;64(3):729–736. [PMC free article] [PubMed] [Google Scholar]
• Okano K, Nakai R, Harasawa M. Endocrine factors in senile osteoporosis. Endocrinol Jpn. 1979 Jun;26(Suppl):23–30. [PubMed] [Google Scholar]
• Lawoyin S, Zerwekh JE, Glass K, Pak CY. Ability of 25-hydroxyvitamin D3 therapy to augment serum 1,25- and 24,25-dihydroxyvitamin D in postmenopausal osteoporosis. J Clin Endocrinol Metab. 1980 Mar;50(3):593–596. [PubMed] [Google Scholar]
• Haussler MR, McCain TA. Basic and clinical concepts related to vitamin D metabolism and action (first of two parts). N Engl J Med. 1977 Nov 3;297(18):974–983. [PubMed] [Google Scholar]
• Taves DR. Minimization: a new method of assigning patients to treatment and control groups. Clin Pharmacol Ther. 1974 May;15(5):443–453. [PubMed] [Google Scholar]
• Arnaud CD, Tsao HS, Littledike T. Radioimmunoassay of human parathyroid hormone in serum. J Clin Invest. 1971 Jan;50(1):21–34. [PMC free article] [PubMed] [Google Scholar]
• Gallagher JC, Riggs BL, Jerpbak CM, Arnaud CD. The effect of age on serum immunoreactive parathyroid hormone in normal and osteoporotic women. J Lab Clin Med. 1980 Mar;95(3):373–385. [PubMed] [Google Scholar]
• Bullamore JR, Marshall DH, Nordin BE, Oldfield WA, Wilkinson R. Measurement of calcium balance and bone turnover by new techniques. Calcif Tissue Res. 1970;(Suppl):93–94. [PubMed] [Google Scholar]
• Wilkinson R. Polyethylene glycol 4000 as a continuously administered non-absorbable faecal marker for metabolic balance studies in human subjects. Gut. 1971 Aug;12(8):654–660. [PMC free article] [PubMed] [Google Scholar]
• Burkinshaw L, Marshall DH, Oxby CB, Spiers FW, Nordin BE, Young MM. Bone turnover model based on a continuously expanding exchangeable calcium pool. Nature. 1969 Apr 12;222(5189):146–148. [PubMed] [Google Scholar]
• Johnson KA, Kelly PJ, Jowsey J. Percutaneous biopsy of the iliac crest. Clin Orthop Relat Res. 1977 Mar-Apr;(123):34–36. [PubMed] [Google Scholar]
• JOWSEY J, PHIL D, KELLY PJ, RIGGS BL, BIANCO AJ, Jr, SCHOLZ DA, GERSHON-COHEN J. QUANTITATIVE MICRORADIOGRAPHIC STUDIES OF NORMAL AND OSTEOPOROTIC BONE. J Bone Joint Surg Am. 1965 Jun;47:785–806. [PubMed] [Google Scholar]
• Wahner HW, Riggs BL, Beabout JW. Diagnosis of osteoporosis: usefulness of photon absorptiometry at the radius. J Nucl Med. 1977 May;18(5):432–437. [PubMed] [Google Scholar]
• Riggs BL, Seeman E, Hodgson SF, Taves DR, O'Fallon WM. Effect of the fluoride/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis. Comparison with conventional therapy. N Engl J Med. 1982 Feb 25;306(8):446–450. [PubMed] [Google Scholar]
• Vitamin-D analogues and renal function. Lancet. 1978 Dec 9;2(8102):1259–1260. [PubMed] [Google Scholar]
• Gray RW, Caldas AE, Wilz DR, Lemann J, Jr, Smith GA, DeLuca HF. Metabolism and excretion of 3H-1,25-(OH)2-vitamin D3 in healthy adults. J Clin Endocrinol Metab. 1978 May;46(5):756–765. [PubMed] [Google Scholar]
• Seeman E, Kumar R, Hunder GG, Scott M, Heath H, 3rd, Riggs BL. Production, degradation, and circulating levels of 1,25-dihydroxyvitamin D in health and in chronic glucocorticoid excess. J Clin Invest. 1980 Oct;66(4):664–669. [PMC free article] [PubMed] [Google Scholar]
• LAFFERTY FW, SPENCER GE, Jr, PEARSON OH. EFFECTS OF ANDROGENS, ESTROGENS AND HIGH CALCIUM INTAKES ON BONE FORMATION AND RESORPTION IN OSTEOPOROSIS. Am J Med. 1964 Apr;36:514–528. [PubMed] [Google Scholar]
• Harris WH, Heaney RP. Skeletal renewal and metabolic bone disease. N Engl J Med. 1969 Jan 30;280(5):253–contd. [PubMed] [Google Scholar]
• Riggs BL, Jowsey J, Goldsmith RS, Kelly PJ, Hoffman DL, Arnaud CD. Short- and long-term effects of estrogen and synthetic anabolic hormone in postmenopausal osteoporosis. J Clin Invest. 1972 Jul;51(7):1659–1663. [PMC free article] [PubMed] [Google Scholar]
• Riggs BL, Jowsey J, Kelly PJ, Hoffman DL, Arnaud CD. Effects of oral therapy with calcium and vitamin D in primary osteoporosis. J Clin Endocrinol Metab. 1976 Jun;42(6):1139–1144. [PubMed] [Google Scholar]
• Reeve J, Meunier PJ, Parsons JA, Bernat M, Bijvoet OL, Courpron P, Edouard C, Klenerman L, Neer RM, Renier JC, et al. Anabolic effect of human parathyroid hormone fragment on trabecular bone in involutional osteoporosis: a multicentre trial. Br Med J. 1980 Jun 7;280(6228):1340–1344. [PMC free article] [PubMed] [Google Scholar]
• Davies M, Mawer EB, Adams PH. Vitamin D metabolism and the response to 1,25-dihydroxycholecalciferol in Osteoporosis. J Clin Endocrinol Metab. 1977 Aug;45(2):199–208. [PubMed] [Google Scholar]
• Marshall DH, Gallagher JC, Guha P, Hanes F, Oldfield W, Nordin BE. The effect of 1alpha-hydroxycholecalciferol and hormone therapy on the calcium balance of post-menopausal osteoporosis. Calcif Tissue Res. 1977 May;22 (Suppl):78–84. [PubMed] [Google Scholar]
• Brickman AS, Coburn JW, Friedman GR, Okamura WH, Massry SG, Norman AW. Comparison of effects of 1 alpha-hydroxy-vitamin D3 and 1,25-dihydroxy-vitamin D3 in man. J Clin Invest. 1976 Jun;57(6):1540–1547. [PMC free article] [PubMed] [Google Scholar]
• Haas HG, Dambacher MA, Guncaga J, Lauffenburger T, Lämmle B, Olah J. 1,25(OH)2 vitamin D3 in osteoporosis--a pilot study. Horm Metab Res. 1979 Feb;11(2):168–171. [PubMed] [Google Scholar]

Articles from Proceedings of the National Academy of Sciences of the United States of America are provided here courtesy of National Academy of Sciences