期刊
OSTEOPOROSIS INTERNATIONAL
卷 20, 期 7, 页码 1259-1266出版社
SPRINGER LONDON LTD
DOI: 10.1007/s00198-008-0799-4
关键词
Alendronate; Bone mineral density; Osteoporosis; Vitamin D deficiency; Vitamin D repletion
资金
- National Osteoporosis Foundation
- National Institutes of Health [K23 RR020343]
We investigated whether osteoporosis therapy with alendronate in postmenopausal patients is equally effective in patients who are vitamin D insufficient as in those who are vitamin D sufficient. We found that vitamin D insufficiency is common among patients with low bone density but that vitamin D insufficiency did not impair response to alendronate. Treatment of vitamin D deficiency leads to significant improvements in bone mineral density (BMD); however, whether insufficiency affects BMD's response to bisphosphonate therapy is unknown. To determine whether vitamin D insufficiency at initiation of alendronate therapy for low BMD affects treatment efficacy, we used data from 1,000 postmenopausal women randomly selected from the vertebral fracture arm (n = 2,027) of the placebo-controlled Fracture Intervention Trial of alendronate. Participants were randomly assigned to placebo (50%) or alendronate therapy and most (83%) to calcium (500 mg/day) and cholecalciferol (250 IU/day). We measured serum 25-hydroxy vitamin D (25OHD) at enrollment, then categorized baseline vitamin D status according to 25OHD concentration ( a parts per thousand currency signaEuro parts per thousand 10 ng/ml = deficient; > 10 but a parts per thousand currency signaEuro parts per thousand 30 ng/ml = insufficient; > 30 ng/ml = sufficient) and used linear regression to compare the effects of alendronate treatment among these categories. At baseline, participants were vitamin D sufficient (14%), insufficient (83%), and deficient (2%). We found that BMD response to therapy at total hip or spine did not vary by vitamin D status at baseline (p for heterogeneity = 0.6). We determined that vitamin D insufficiency is common among participants with low BMD. However, vitamin D status at initiation of therapy does not affect BMD's response to alendronate, when it is coadministered with cholecalciferol and calcium.
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