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25 dihydroxycholecalciferol and calcium therapy in osteoporosis with calcium malabsorption dose response relationship of calcium absorption and indices of bone turnover

25 dihydroxycholecalciferol and calcium therapy in osteoporosis with calcium malabsorption dose response relationship of calcium absorption and indices of bone turnover

Mineral & Electrolyte Metabolism: 35-40

Some effects of small doses of 1,25-dihydroxycalciferol (calcitriol) and calcium [Ca], either combined or separately were studied in 45 patients with osteoporosis and malabsorption of Ca. In 24 patients on 0.25 .mu.g/[day]d of calcitriol the hourly fractional rate of radiocalcium absorption rose from 0.37 .+-. 0.02 to 0.55 .+-. 0.04 (P < 0.001) and in 21 patients on 0.50 .mu.g/d it rose from 0.36 .+-. 0.02 to 0.69 .+-. 0.05 (P < 0.001). These responses were seen within 5 days and were not increased further at 6 wk-3 mo. The combined therapy significantly reduced the fasting urinary hydroxyproline/creatine ratio (OHPr/Cr) and plasma alkaline phosphatase activity (ALP) in 6-12 wk, the smaller dose of calcitriol (0.25 .mu.g/d) being as effective as the larger one (0.50 .mu.g/d) in this respect. Ca alone (1 g/d) had no effect and calcitriol alone (0.25 mcg/d) had a lesser effect on both OHPr/Cr and ALP than the combined therapy. The falls in OHPr/Cr and ALP tended to be greatest in the cases with the highest initial levels but constituted only partial suppression of these variables towards the theoretical non-bone components. Evidently, treatment with calcitriol and Ca suppresses bone resorption in osteoporosis associated with malabsorption of Ca and is more effective than Ca or calcitriol given alone.

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