Osteoporosis International

, Volume 6, Issue 4, pp 284–290

A comparison of the effects of alfacalcidol treatment and vitamin D2 supplementation on calcium absorption in elderly women with vertebral fractures

  • R. M. Francis
  • I. T. Boyle
  • C. Moniz
  • A. M. Sutcliffe
  • B. S. Davis
  • G. H. Beastall
  • R. A. Cowan
  • N. Downes
Original Article

DOI: 10.1007/BF01623386

Cite this article as:
Francis, R.M., Boyle, I.T., Moniz, C. et al. Osteoporosis Int (1996) 6: 284. doi:10.1007/BF01623386

Abstract

Although vitamin D supplementation in the frail elderly improves calcium absorption, suppresses parathyroid hormone, decreases bone loss and reduces the risk of fractures, such treatment may be ineffective in patients with vertebral osteoporosis, because of impaired vitamin D metabolism or resistance to the action of vitamin D metabolites on the bowel. We have therefore performed a randomized, single masked study comparing the effects of alfacalcidol treatment (0.25 µg twice daily) and vitamin D2 supplementation (500-1000 units daily) on calcium absorption and bone turnover in 46 elderly women (median age 69 years, range 64–79 years) with radiological evidence of vertebral fractures. Serum 25-hydroxyvitamin D increased significantly after 3 and 6 months of treatment with vitamin D2 (p<0.001), but was unchanged in the group receiving alfacalcidol. Serum 1,25-dihydroxyvitamin D did not change significantly in either group over the study period. Fractional45Ca absorption increased after 3 months of treatment with alfacalcidol (p<0.05), but was unchanged with vitamin D2. There was also a reduction in plasma intact parathyroid hormone and serum alkaline phosphatase after 6 months of treatment with alfacalcidol (p<0.05) which was not seen in the group receiving vitamin D2. Our study shows that vitamin D2 supplementation is ineffective in stimulating calcium absorption in elderly women with vertebral osteoporosis. By increasing calcium absorption in such patients, alfacalcidol may prove more effective than vitamin D in the management of vertebral osteoporosis.

Keywords

Alfacalcidol Calcium absorption Elderly Osteoporosis Vertebral fractures Vitamin D2 

Copyright information

© European Foundation for Osteoporosis 1996

Authors and Affiliations

  • R. M. Francis
    • 1
  • I. T. Boyle
    • 2
  • C. Moniz
    • 3
  • A. M. Sutcliffe
    • 1
  • B. S. Davis
    • 2
  • G. H. Beastall
    • 2
  • R. A. Cowan
    • 2
  • N. Downes
    • 4
  1. 1.Department of Medicine (Geriatrics)University of Newcastle upon Tyne, Newcastle General HospitalNewcastle upon Tyne
  2. 2.University Departments of Medicine and Pathological BiochemistryRoyal InfirmaryGlasgow
  3. 3.Department of Clinical BiochemistryKings College HospitalLondon
  4. 4.Medical DepartmentLeo Laboratories Limited, Princes RisboroughUK
  5. 5.Musculoskeletal UnitFreeman HospitalNewcastle upon TyneUK