Minimum Required Vitamin D Level for Optimal Increase in Bone Mineral Density with Alendronate Treatment in Osteoporotic Women

被引:66
作者
Ishijima, Muneaki [1 ,2 ]
Sakamoto, Yuko [1 ]
Yamanaka, Makoto [1 ]
Tokita, Akifumi [1 ,4 ]
Kitahara, Keiichiro [1 ]
Kaneko, Haruka [1 ]
Kurosawa, Hisashi [1 ,2 ,3 ]
机构
[1] Juntendo Univ, Sch Med, Dept Orthopaed, Bunkyo Ku, Tokyo 1138421, Japan
[2] Juntendo Univ, Grad Sch Med, Sportol Ctr, Tokyo 1138421, Japan
[3] Juntendo Univ, Grad Sch Med, Dept Med Motor Organ, Tokyo 1138421, Japan
[4] Juntendo Univ, Sch Med, Dept Pediat, Tokyo 1138421, Japan
关键词
Osteoporosis; Vitamin D; Bone mineral density; Bone densitometry; Bisphosphonate; Akaike's information criterion (AIC); OSTEOPENIC POSTMENOPAUSAL WOMEN; D INADEQUACY; FRACTURES; CALCIUM; BISPHOSPHONATES; PREVALENCE; PREVENTION; THERAPY; JAPAN;
D O I
10.1007/s00223-009-9295-x
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Vitamin D insufficiency and deficiency are common in the elderly. Most previous studies using alendronate have used vitamin D supplementation regardless of individual vitamin D status. However, the minimum required vitamin D levels for the efficacy of alendronate treatment of osteoporosis remain unclear. Fifty-two postmenopausal women, diagnosed with osteoporosis, were enrolled in this prospective study, in which they took 5 mg of alendronate daily for 6 months without any supplements. Associations between baseline factors and their changes during the treatment and the change in the lumbar spine bone mineral density (LS-BMD) were examined. The most appropriate cut-off level of 25-hydroxyvitamin D (25[OH]D) for the optimal increase in LS-BMD with alendronate was determined using the Akaike information criterion statistical criterion. Overall, alendronate treatment significantly increased LS-BMD by 4.7%. The basal serum 25(OH)D and change in urinary NTX were significantly associated with the increase in LS-BMD. The increase in LS-BMD between the two groups was not different when comparing those with baseline 25(OH)D above vs. below 30 ng/ml. However, 25(OH)D of 25 ng/ml was determined to be the minimum required vitamin D level for an adequate effect of alendronate. Vitamin D status may affect the increase in LS-BMD with alendronate treatment in individuals being treated for osteoporosis, and a 25(OH)D level > 25 ng/ml appears to be required for an optimal LS-BMD response.
引用
收藏
页码:398 / 404
页数:7
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