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Horm Metab Res 1979; 11(2): 168-171
DOI: 10.1055/s-0028-1092703
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© Georg Thieme Verlag KG Stuttgart · New York

1,25 (OH)2 Vitamin D3 in Osteoporosis - A Pilot Study[*] [**]

H. G. Haas1 , M. A. Dambacher1 , J.  Guncaga3 , T.  Lauffenburger1 , B.  Lämmle1 , J.  Olah2
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Basel, Kantonsspital, Basel
  • 2Department of Anatomy, University of Berne, Berne
  • 3F. Hoffmann-La Roche, Basel, Switzerland
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Publikationsdatum:
17. Dezember 2008 (online)

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Abstract

Intestinal calcium absorption may be low in postmenopausal osteoporosis due to a failure of the kidney to produce sufficient quantities of the active vitamin D metabolite 1,25 (OH)2D3. Based on this findings four patients with overt osteoporosis were treated for six months with 0.5 µg 1,25 (OH)2D3/day. Base-line studies under metabolic conditions were repeated after six months of treatment. Bone formation (BF) and bone resorption (BR) were assessed by measuring alkaline serum phosphatase (aPh), urinary hydroxyproline (HyPro), calcium (Ca) accretion (Vo+) and Ca mobilization rate (Vo-) as well as histomorphometric indices of BF and BR in paired bone biopsies. Net effects of treatment were checked by assessing the Ca balance (ΔCa) and the volume density (Vv) of cancellous iliac crest bone. In addition, the serum ionized calcium (SCa2+), the urinary calcium (UCa), and the fractional intestinal Ca absorption (α) were followed at shorter intervals.

The main effect of l,25(OH)2D3 was observed on Ca metabolism: due to a marked increase of α from 21 to 45% SCa2+ rose significantly together with a doubling of UCa. These changes resulted in a positive ΔCa in three out of four subjects. The fourth patient with an initially high α lost more Ca during treatment. A minor effect was observed on bone remodeling, BR indices responding more than BF indices in three out of four subjects. In these patients, the volume density of cancellous bone (Vv) increased on 1,25 (OH)2D3. The fourth patient lost some bone due to an increase of BR while BF decreased slightly.

These data indicate that l,25(OH)2D3 may be beneficial in correcting the Ca absorption defect in postmenopausal osteoporosis and thus inhibiting further bone loss. However, such a favorable response can be expected only in patients with a low intestinal Ca absorption.

Key words

1,25(OH)2 - Vitamin D3 - Osteoporosis - Calcium Balance - Calcium Absorption

1 Presented in part at the Vlth Parathyroid Conference, Vancouver/BC, Canada, June 15-17, 1977

2 Supported by the Swiss National Science Foundation, Grants 3.8710.72 and 3.565.75

1 Presented in part at the Vlth Parathyroid Conference, Vancouver/BC, Canada, June 15-17, 1977

2 Supported by the Swiss National Science Foundation, Grants 3.8710.72 and 3.565.75

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