RESEARCH - Relative value of plain vitamin D and of biologically active vitamin D in the treatment of osteoporosis

October 27, 2006

Z Rheumatol. 2006 Aug 30; [Epub ahead of print]

[Relative value of plain vitamin D and of biologically active vitamin D in

the prevention and treatment of osteoporosis.]

[Article in German]

Praxis fur Innere Medizin, Salinenstrasse 8, 83435, Bad Reichenhall,

Deutschland, Dr.Scharla@....

Vitamin D metabolism has an important role in the pathogenesis of

osteoporosis. Vitamin D deficiency is very common in elderly people in

central Europe. This leads to secondary hyperparathyroidism and to increased

bone resorption, resulting in osteoporosis. Combined with the elevated risk

of falling that results from vitamin D deficiency, this increases the

frequency of bone fractures. Severe vitamin D deficiency also causes

impaired bone mineralization (osteomalacia). Controlled intervention trials

with native vitamin D (and calcium) yielded no consistent results in terms

of the prevention of extravertebral fractures. It appears likely that

treatment with plain vitamin D is effective only in populations with vitamin

D deficiency.Treatment with active vitamin D (1-alpha-hydroxylated

metabolites such as alfacalcidol) has to be considered a pharmacological

intervention that exerts pleiotropic effects on the gut (calcium

absorption), bone (stimulation of formation), muscle (decreasing of the risk

of falling), and immune system. Target groups are patients with disturbed

vitamin D metabolism (renal insufficiency, glucocorticoid therapy,

inflammatory disease such as rheumatoid arthritis). Alfacalcidol can prevent

glucocorticoid-induced bone loss (high-grade evidence). In comparative

studies alfacalcidol was superior to plain vitamin D.

PMID: 16944081

ctPlus & list_uids=16944081

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

s Hopkins Medicine

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