porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo2014121-24porozendo-8873Research ArticleСтатьиArticlesАЛЬФАКАЛЬЦИДОЛ ИЛИ КОЛЕКАЛЬЦИФЕРОЛ В КОМБИНАЦИИ С ИБАНДРОНОВОЙ КИСЛОТОЙ ПРИ ЛЕЧЕНИИ ПОСТМЕНОПАУЗАЛЬНОГО СИСТЕМНОГО ОСТЕОПОРОЗАAL'FAKAL'TsIDOL ILI KOLEKAL'TsIFEROL V KOMBINATsII S IBANDRONOVOY KISLOTOY PRI LEChENII POSTMENOPAUZAL'NOGO SISTEMNOGO OSTEOPOROZAРОДИОНОВАС СRODIONOVAS S

проф. д.м.н., рук. Научно-клинического центра остеопороза ЦИТО

-ЕЛОВОЙ-ВРОНСКИЙА АELOVOY-VRONSKIYA A

аспирант научно-клинического центра остеопороза ЦИТО

-БЕРНАКЕВИЧА ИBERNAKEVIChA I

к.м.н. руководитель лаборатории биохимии ЦИТО

-Центральный научно-исследовательский институт травматологии и ортопедии им. Н.Н. Приорова201415122014171№1 (2014)2124Copyright © РОДИОНОВА С.С., ЕЛОВОЙ-ВРОНСКИЙ А.А., БЕРНАКЕВИЧ А.И., 20142014РОДИОНОВА С.С., ЕЛОВОЙ-ВРОНСКИЙ А.А., БЕРНАКЕВИЧ А.И.RODIONOVA S.S., ELOVOY-VRONSKIY A.A., BERNAKEVICh A.I.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/8873

Проведенное сравнительное исследование применения ибандроновой кислоты (Бонвива) с двумя формами витамина Д (колекальциферол и альфкальцидол (альфаД3-тева) показало, что у некоторых больных при исходно незначительном повышении уровня маркеров резорбции колекациферол, в отличие от альфакальцидола, не всегда позволяет предотвратить развитие гипокальциемии и вторичного гиперпаратиреоза. Кроме того, назначение колекальциферола при наличии у пациентов соматической патологии, оказывающей влияние на его метаболизм, не исключает возможности развития скрытой гипокальциемии как проявления чрезмерного угнетения ремоделирования под влиянием ибандроната. Клиническим выражением чрезмерного угнетения ремоделирования и недостаточности Д гормона в проведенном исследовании стал меньший прирост МПК в поясничном отделе, отсутствие достоверного прироста в шейке бедра и большая частота переломов в группе, получавшей колекальциферол, по сравнению с группой, получавшей альфакальцидол. Повышение концентрации 25(ОН)Д в сыворотке крови у пациентов на фоне приема колекальциферола не гарантирует увеличения уровня Д-гормона.

Alfacalcidol or colecalciferol in combination with ibandronic aciWhen a comparative study of the ibandronic acid (Bonviva) using with two forms of vitamin D (colecalciferol and alfacalcidol) was conducted, it has been showed that in some patients with initially a slight increase in the level of resorption markers colecalciferol, in contradistinction to alfacalcidol, not always it is possible to prevent the development of hypocalcemia and secondary hyperparathyroidism. As well, the appointment of colecalciferol may lead to hypocalcemia as a hidden manifestation of excessive oppression remodeling influenced ibandronate in patients with the presence of somatic pathology with an impact on vitamin D metabolism. In the current study, the clinical confirmation of excessive oppression remodeling and failure D hormone was the smaller increase of BMD at lumbar, no significant increase in femoral neck fractures and a higher incidence in the group receiving colecalciferol compared to the group receiving alfacalcidol. Increasing of 25(OH)D concentrations in the blood of patients while taking colecalciferol doesn’t guarantees rising of D-hormone.

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The authors declare that there are no conflicts of interest present.