Conclusion
Vitamin D deficiency in edlery people can cause secondary hyperparathyroidism, leading to an elevated risk of femoral neck fracture. This risk can be reduced by plain vitamin D replenishment. Osteoblast dysfunction associated with vitamin D deficiency can be partially reduced by vitamin D replenishment. These effects of vitamin D are, however, dose-dependent, and it is unknown whether or not increased bone resorption can be suppressed by vitamin D replenishment. We may definitely say that the amount of vitamin D ingested needs to be increased to keep bone metabolism at a proper level in elderly individuals. It is, however, unknown whether or not the effect of vitamin D replenishment in reducing the risk of fracture is longlasting. Administration of 1,25(OH)2D3 to postmenopausal osteoporotic women without vitamin D deficiency can suppress bone resorption. This effect seems to depend on the doses employed and the VDR genotypes. In some populations, the risk of vertebral compression fractures seems to be reduced by active type vitamin D treatment. Additional studies for periods longer than the previous studies (1–3 years) are needed.
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References
Toss G, Almqvist S, Larsson L, et al. Vitamin D deficiency in welfare institutions for the aged. Acta Med Scand 1980;208:87–9.
MacLaughlin J, Holick MF. Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 1985;76:1536–8.
Tsai KS, Heath H III, Kumar R, et al. Impaired vitamin D metabolism with aging in women: possible role in pathogenesis of senile osteoporosis. J Clin Invest 1984;73:1668–72.
Epstein S, Bryce G, Hinman JW, et al. The influence of age on bone mineral regulating hormones. Bone 1996;7:421–5.
Gallagher JC, Riggs BL, Eisman J, et al. Intestinal calcium absorption and serum vitamin D metabolites in normal subjects and osteoporotic patients: effect of age and dietary calcium. J Clin Invest 1979;64:729–36.
Ebeling PR, Sandgrem ME, DiMagno EP, et al. Evidence of an age-related decrease in intestinal responsiveness to vitamin D: relationship between serum 1,25-dihydroxyvitamin D and intestinal vitamin D receptor concentration in normal women. J Clin Endocrinol Metab 1992;75:176–82.
Eastell R, Yergey AL, Vieira NE, et al. Interrelationship among vitamin D metabolism, true calcium absorption, parathyroid function, and age in women: evidence of an age-related intestinal resistance to 1,25-dihydroxyvitamin D actin. J Bone Miner Res 1991;6:125–32.
Landin-Wilhelmsen K, Wilhelmsen L, Lappas G, et al. Serum intact parathyroid hormone in a random population of sample of men and women: relationship to anthropometry, life-style factors, blood pressure and vitamin D. Calcif Tissue Int 1995;56:104–8.
Garnero P, Hausherr E, Chapuy MC, et al. Markers of bone resorption predict hip fracture in elderly women: the EPIDOS prospective study. J Bone Miner Res 1996;11:1531–8.
Mohan S, Strong DD, Lembert UG, et al. Studies on the regulation of insulin-likee growth factor binding protein (IGFBP)-3 and BP-4 production in human bone cells. Acta Endocrinol 1992;127:555–64.
Lian J, Stewart C, Puchacz E, et al. Structure of the rat osteocalcin gene and regulation of vitamin D-dependent expression. Proc Natl Acad Sei USA 1989;86:1143–7.
Furie B, Furie BC. Molecular basis of vitamin K-dependent gamma-carboxylation. Blood 1990;75:1753–62.
Platalech L, Guillaumont M, Leclercq M, et al. Impaired carboxylation of serum osteocalcin in elderly women. J Bone Miner Res 1991;6:1211–6.
Szulc P, Chapuy MC, Meunier PJ, et al. Serum undercarboxylated osteocalcin is a marker of the risk of hip fracture: a three year follow-up study. Bone 1996;18:487–8.
Szulc P, Chapuy MC, Meunier PJ, et al. Serum undercarboxylated osteocalcin is a marker of the risk of hip fracture in elderly women. J Clin Invest 1993;17:1769–74.
Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 1992;327:1637–42.
Chapuy MC, Arlot ME, Delmas PD, et al. Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. BMJ 1994;308:1081–2.
Heikinheimo RJ, Inkovaara JA, Jarju EJ, et al. Annual injection of vitamin D and fractures of aged bone. Calcif Tissue Int 1992;51:105–10.
Lips P, Graffmans WC, Ooms WE, et al. Vitamin D supplementation and fracture incidence in elderly persons: a randomized double-controlled clinical trial. Ann Intern Med 1996;124:400–6.
Ooms ME, Roos JC, Bezemer PD, et al. Prevention of bone loss by vitamin D supplementation in elderly women: a randomized double-blind trial. J Clin Endocrinol Metab 1995;80:1052–8.
Dawson-Hughes B, Haris SS, Krall EA, et al. Rates of bone loss in postmenopausal women randomly assigned to one of two dosages of vitamin D. Am J Clin Nutr 1995;61:1140–5.
Lips P, Wiersinga A, van Ginel FC, et al. The effect of vitamin D supplementation on vitamin D status and parathyroid function in elderly subjects. J Clin Endocrinol Metab 1988;67:644–50.
Khaw KY, Scragg R, Murphy S. Single-dose cholecalciferol suppresses the winter increase in parathyroid hormone concentrations in healthy older men and women. Am J Clin Nutr 1990;52:701–6.
Himmelstein S, Clements TL, Rubin A, et al. Vitamin D supplementation in elderly nursing home residents increases 25(OH)D but not 1,25(OH)2D. Am J Clin Nutr 1990;52:701–6.
Gallagher JC, Riggs BL, et al. The effect of calcitriol on patients with postmenopausal osteoporosis with special reference to fracture frequency. Proc Soc Exp Biol Med 1989;19:287–292.
Tilyard MW, Spears GFS, Com B, et al. Treatment of postmenopausal osteoporosis with calcitriol or calcium. N Engl J Med 1992;326:357–62.
Orimo M, Shiraki M, Hayashi Y, et al. Reduced occurrence of vertebral crush fractures in senile osteoporosis treated with 1α(OH)-vitamin D3. Bone Miner 1987;3:47–52.
Hayashi Y, Fujita T, Inoue T. Decrease of vertebral fracture in osteoporotic patients by administration of 1α-(OH)D3. J Bone Miner Metab 1992;10:184–8.
Itoi E, Yamada Y, Sakurai M, et al. Long-term treatment with lahydroxyvitamin D3 with calcium supplement in spinal osteoporotic patients. Orthopedics 1992;15:1409–14.
Orimo H, Shiraki M, Hoshino T, et al. Effects of loe-hydroxyvitamin D3 on lumbar bone mineral density and vertebral fractures in patients with postmenopausal osteoporosis. Calcif Tissue Int 1994;54:370–6.
Nakamura T. The importance of genetic and nutritional factors in responses to vitamin D and its analogs in osteoporotic patients. Calcif Tissue Int 1997;60:401–8.
Aloia JF, Vaswani A, Yeh JK, et al. Calcitriol in the treatment of postmenopausal osteoporosis. Am J Med 1987;84:401–8.
Gallagher JC, Goldgar D. Treatment of postmenopausal osteoporosis with high doses of synthetic calcitriol. Ann Intern Med 1990;113:649–55.
Christiansen C, Christiansen MS, Rodbro P, et al. Effect of 1,25-dihydroxyvitamin D3 in itself or combined with hormone treatment in preventing postmenopausal osteoporosis. Eur J Clin Invest 1981;11:305–9.
Falch JA, Ogdegaard OR, Finnanger AM, et al. Postmenopausal osteoporosis: no effect of three years treatment with 1,25-dihydoroxycholecalciferol. Acta Med Scand 1987;221:199–204.
Oft MS, Chesnut CH. Calcitriol is not effective in postmenopau-sal osteoporosis. Ann Intern Med 1989;110:267–74.
Chen JT, Tanaka N, Kato T, et al. Effect of 1α-hydroxyvitamin D3 treatment decreases bone turnover and modulates calcium regulating hormones in early-postmenopausal women. Bone 1997; in press.
Christiansen C, Christiansen MS, McNair P, et al. Prevention of early postmenopausal bone loss: controlled 2-year study in 315 normal females. Eur J Clin Invest 1980;10:273–9.
Tsurukami H, Nakamura T, Suzuki K, et al. A novel synthetic vitamin D analogue, 2β-(3-hydroxypropoxy) 1α,25-dihydroxy-vitamin D3 (ED-71), increases bone mass by stimulating the bone formation in normal and ovariectomized rats. Calcif Tissue Int 1994;54:142–9.
Morrison NA, Qi JC, Tokita A, et al. Prediction of bone density from vitamin D receptor allele. Nature 1994;367:284–7.
Peacock M. Vitamin D receptor gene alleles and osteoporosis: a constrasting view [editorial]. J Bone Miner Res 1995;10:1294–7.
Garnero P, Borel O, Sornay-Rendu E, et al. Vitamin D receptor gene polymorphisms do not predict bone turnover and bone mass in healthy premenopausal women. J Bone Miner Res 1995;10:1283–8.
Matsuyama T, Ishii S, Tokita A, et al. Vitamin D receptor genotypes and bone mineral density. Lancet 1995;345:1238–9.
Dawson-Hughes B, Harris SS, Finneran S. Calcium absorption on high and low calcium intakes in relation to vitamin D receptor genotype. J Clin Endocrinol Metab 1995;80:3657–61.
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Nakamura, T. Vitamin D for the treatment of osteoporosis. Osteoporos Int 7 (Suppl 3), 155–158 (1997). https://doi.org/10.1007/BF03194363
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DOI: https://doi.org/10.1007/BF03194363