Calcium and vitamin D in osteoporosis

Abstract

In Japan where calcium and vitamin D deficiency is more prominent than in USA and Europe, the role of calcium and vitamin D in the development of osteoporosis and their role in the treatment of osteoporosis has been intensively studied. Females absorb calcium from the intestine less efficiently than in males, espedally potmenopausally. Serum 25-OH-D is lower in females, especially osteoporotics. Calcitonin secretion also decreases in postmenopausal females. For these reasons, 1α(OH) vitamin D and elcatonin, an eel calcitonin derivative, are the two most widely used agents in the treatment of osteoporosis in Japan, where estrogen is scarcely used. Increase of bone mass and decreased fracture rate was demonstrated with reference to the use of 1α(OH) vitamin D₃ Low dose (10u twice a week) intermittent calcitonin therapy was shown to exert a dramatic analgesic effect on lumbago and backache and also to preserve bone mass according to DXA and QCT measurements. Active absorbable calcium, an electrolyzed oyster shell preparation, is more favorably absorbed than calcium carbonate, aslo increased cortical bone mass over a ceriod of 2 years, and spinal trabecular bone to a lesser extent.