porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo2016122-27porozendo-8942Research ArticleСтатьиArticlesВЛИЯНИЕ 5-ЛЕТНЕГО ИСПОЛЬЗОВАНИЯ АЛЬФАКАЛЬЦИДОЛА В КОМБИНАЦИИ С КАРБОНАТОМ КАЛЬЦИЯ НА МИНЕРАЛЬНУЮ ПЛОТНОСТЬ КОСТНОЙ ТКАНИ ПРИ ПЕРВИЧНЫХ ФОРМАХ СИСТЕМНОГО ОСТЕОПОРОЗА У МУЖЧИНEFFECT OF A 5-YEAR ALFACALCIDOL TREATMENT IN COMBINATION WITH CALCIUM CARBONATE ON BONE MINERAL DENSITY IN THE PRIMARY FORMS OF SYSTEMIC OSTEOPOROSIS IN MENРодионоваС СRodionovaS S

д.м.н., профессор научно-клинического центра остеопороза

-ХакимовУР RKhakimovU R

аспирант научно-клинического центра остеопороза

-ФГБУ«ЦИТО им Н.Н. Приорова» МЗ РФ201615122016191№1 (2016)2227Copyright © Родионова С.С., Хакимов У.R., 20162016Родионова С.С., Хакимов У.R.Rodionova S.S., Khakimov U.R.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/8942

Представлены результаты 5- летнего использования комбинации альфакальцидола с карбонатом кальция на минеральную плотность костной ткани у 47мужчин с первичными формами системного остеопороза, которые свидетельствуют об эффективности такого лечения пациентов с низкооборотной и нормооборотной формами остеопороза. Достоверный прирост МПК L1-L4 отмечен после первого года лечения, в шейке бедра - только после 3-х лет лечения. Сравнения величины прироста МПК по годам показало, что эффективность лечения увеличивается с его продолжительностью. Мониторирование показателей Са крови и мочи, проводимое 1 раз в 3 месяца до 1-го года лечения и 1 раз в 6 месяцев в последующие годы, позволяет исключить возможность гиперкальциемии на протяжении всего периода лечения и обеспечить персонализацию лечения

The article presents the results of 5-year treatment with a combination of alfacalcidol and calcium carbonate in 47 men with primary forms of systemic osteoporosis. The obtained results show the effectiveness of this treatment in patients with low and normal turnover forms of osteoporosis. Significant increase of BMD at L1-L4 was observed after the first year of treatment, at the Neck region - after 3-rd year of treatment. Comparison of the magnitude of the annual increase of BMD has shown that the effectiveness of the treatment increases with its duration. The possibility of hypercalcemia was excluded by monitoring of calcium levels in blood and urine at intervals of 3-6 months throughout the treatment period.

остеопороз у мужчинпервичные формы остеопороза у мужчинальфакальцидолкарбонат кальцияМПКDXAosteoporosisprimary osteoporosisosteoporosis in menalfacalcidolcalcium carbonateBMDDXAReferencesRiggs BL1, Melton LJ, Robb RA, Camp JJ, Atkinson EJ, McDaniel L, Amin S, Rouleau PA, Khosla S. A population-based assessment of rates of bone loss at multiple skeletal sites: evidence for substantial trabecular bone loss in young adult women and men. J Bone Miner Res. 2008 Feb;23(2):205-14Riggs BL1, Melton LJ, Robb RA, Camp JJ, Atkinson EJ, McDaniel L, Amin S, Rouleau PA, Khosla S. A population-based assessment of rates of bone loss at multiple skeletal sites: evidence for substantial trabecular bone loss in young adult women and men. J Bone Miner Res. 2008 Feb;23(2):205-14Nuti R1, Bianchi G, Brandi ML, Caudarella R, D’Erasmo E, Fiore C, Isaia GC, Luisetto G, Muratore M, Oriente P, Ortolani S. Superiority of alfacalcidol compared to vitamin D plus calcium in lumbar bone mineral density in postmenopausal osteoporosis. Rheumatol Int. 2006 Mar;26(5):445-53. Epub 2005 Nov 10Nuti R1, Bianchi G, Brandi ML, Caudarella R, D’Erasmo E, Fiore C, Isaia GC, Luisetto G, Muratore M, Oriente P, Ortolani S. Superiority of alfacalcidol compared to vitamin D plus calcium in lumbar bone mineral density in postmenopausal osteoporosis. Rheumatol Int. 2006 Mar;26(5):445-53. Epub 2005 Nov 10Dukas L1, Bischoff HA, Lindpaintner LS, Schacht E, Birkner-Binder D, Damm TN, Thalmann B, Stähelin HB. Alfacalcidol reduces the number of fallers in a community-dwelling elderly population with a minimum calcium intake of more than 500 mg daily. J Am Geriatr Soc. 2004 Feb;52(2):230-6.Dukas L1, Bischoff HA, Lindpaintner LS, Schacht E, Birkner-Binder D, Damm TN, Thalmann B, Stähelin HB. Alfacalcidol reduces the number of fallers in a community-dwelling elderly population with a minimum calcium intake of more than 500 mg daily. J Am Geriatr Soc. 2004 Feb;52(2):230-6.Hirofumi Tsugeno , Mutsuo Nakai, Makoto Okamoto, Tadashi Yokoi, Shingo Takata, Norikazu Nishida, Kozo Ashida, Fumihiro Mitsunobu, Haruo Yuki and 2 more Assessment of Etidronic Acid plus Alfacalcidol for the Treatment of Osteopenia in Steroid-Dependent Asthmatics Clinical Drug Investigation February 2003, Issue 2, pp 99-105 First online: 17 September 2012Hirofumi Tsugeno , Mutsuo Nakai, Makoto Okamoto, Tadashi Yokoi, Shingo Takata, Norikazu Nishida, Kozo Ashida, Fumihiro Mitsunobu, Haruo Yuki and 2 more Assessment of Etidronic Acid plus Alfacalcidol for the Treatment of Osteopenia in Steroid-Dependent Asthmatics Clinical Drug Investigation February 2003, Issue 2, pp 99-105 First online: 17 September 2012Gallagher JC1, Fowler SE, Detter JR, Sherman SS. Combination treatment with estrogen and calcitriol in the prevention of age-related bone loss. J Clin Endocrinol Metab. 2001 Aug;86(8):3618-28Gallagher JC1, Fowler SE, Detter JR, Sherman SS. Combination treatment with estrogen and calcitriol in the prevention of age-related bone loss. J Clin Endocrinol Metab. 2001 Aug;86(8):3618-28Стентон, Гланц Медико биологическая статистика 1999 г 438 стр.Стентон, Гланц Медико биологическая статистика 1999 г 438 стр.Shiraishi A1, Takeda S, Masaki T, Higuchi Y, Uchiyama Y, Kubodera N, Sato K, Ikeda K, Nakamura T, Matsumoto T, Ogata E. Alfacalcidol inhibits bone resorption and stimulates formation in an ovariectomized rat model of osteoporosis: distinct actions from estrogen. J Bone Miner Res. 2000 Apr;15(4):770-9.Shiraishi A1, Takeda S, Masaki T, Higuchi Y, Uchiyama Y, Kubodera N, Sato K, Ikeda K, Nakamura T, Matsumoto T, Ogata E. Alfacalcidol inhibits bone resorption and stimulates formation in an ovariectomized rat model of osteoporosis: distinct actions from estrogen. J Bone Miner Res. 2000 Apr;15(4):770-9.Suda T1, Takahashi F, Takahashi N. Bone effects of vitamin D - Discrepancies between in vivo and in vitro studies. Arch Biochem Biophys. 2012 Jul 1;523(1):22-9. doi: 10.1016/j.abb.2011.11.011. Epub 2011 Nov 15.Suda T1, Takahashi F, Takahashi N. Bone effects of vitamin D - Discrepancies between in vivo and in vitro studies. Arch Biochem Biophys. 2012 Jul 1;523(1):22-9. doi: 10.1016/j.abb.2011.11.011. Epub 2011 Nov 15.Родионова С.С., Колондасв А.Ф. Мунина Л.И Three years results of alfacalcidol use in patients with osteoporosis. Osteoporosis International. - 1998. - Vol. 8, Suppl.3Родионова С.С., Колондасв А.Ф. Мунина Л.И Three years results of alfacalcidol use in patients with osteoporosis. Osteoporosis International. - 1998. - Vol. 8, Suppl.3Dambacher MA1, Neff M, Kissling R, Qin L. Highly precise peripheral quantitative computed tomography for the evaluation of bone density, loss of bone density and structures. Consequences for prophylaxis and treatment. Drugs Aging. 1998;12 Suppl 1:15-24.Dambacher MA1, Neff M, Kissling R, Qin L. Highly precise peripheral quantitative computed tomography for the evaluation of bone density, loss of bone density and structures. Consequences for prophylaxis and treatment. Drugs Aging. 1998;12 Suppl 1:15-24.William Lau David J Baylink Treatment of 1,25(OH)2D3 (D-hormone) deficiency/resistance with D-hormone and analogs. Osteologie 2001; 10: 28-39 K-HWilliam Lau David J Baylink Treatment of 1,25(OH)2D3 (D-hormone) deficiency/resistance with D-hormone and analogs. Osteologie 2001; 10: 28-39 K-HRinge JD1, Schacht E. Prevention and therapy of osteoporosis: the roles of plain vitamin D and alfacalcidol. Rheumatol Int. 2004 Jul;24(4):189-97. Epub 2004 Jun 30Ringe JD1, Schacht E. Prevention and therapy of osteoporosis: the roles of plain vitamin D and alfacalcidol. Rheumatol Int. 2004 Jul;24(4):189-97. Epub 2004 Jun 30Endo I1, Inoue D, Mitsui T, Umaki Y, Akaike M, Yoshizawa T, Kato S, Matsumoto T. Deletion of vitamin D receptor gene in mice results in abnormal skeletal muscle development with deregulated expression of myoregulatory transcription factors. Endocrinology. 2003 Dec; 144(12):5138 44. Epub 2003 Aug 13Endo I1, Inoue D, Mitsui T, Umaki Y, Akaike M, Yoshizawa T, Kato S, Matsumoto T. Deletion of vitamin D receptor gene in mice results in abnormal skeletal muscle development with deregulated expression of myoregulatory transcription factors. Endocrinology. 2003 Dec; 144(12):5138 44. Epub 2003 Aug 13Varenna M1, Binelli L, Casari S, Zucchi F, Sinigaglia L. Effects of dietary calcium intake on body weight and prevalence of osteoporosis in early postmenopausal women. Am J Clin Nutr. 2007 Sep; 86(3):639-44Varenna M1, Binelli L, Casari S, Zucchi F, Sinigaglia L. Effects of dietary calcium intake on body weight and prevalence of osteoporosis in early postmenopausal women. Am J Clin Nutr. 2007 Sep; 86(3):639-44Ohgitani S, Fujita T. Calcium decreases urinary oxalate Article in Japanese Nihon Ronen Igakkai Zasshi. 2000 Oct; 37(10):805-10Ohgitani S, Fujita T. Calcium decreases urinary oxalate Article in Japanese Nihon Ronen Igakkai Zasshi. 2000 Oct; 37(10):805-10Xia Wang, Hongxia Chen, Yingying Ouyang, Jun Liu, Gang Zhao, Wei Bao,corresponding author and Maosheng Yancorresponding author. Dietary calcium intake and mortality risk from cardiovascular disease and all causes: a meta-analysis of prospective cohort studies BMC Med. 2014; 12: 158.Published online 2014 Sep 25. doi: 10.1186/ s12916-014-0158-6Xia Wang, Hongxia Chen, Yingying Ouyang, Jun Liu, Gang Zhao, Wei Bao,corresponding author and Maosheng Yancorresponding author. Dietary calcium intake and mortality risk from cardiovascular disease and all causes: a meta-analysis of prospective cohort studies BMC Med. 2014; 12: 158.Published online 2014 Sep 25. doi: 10.1186/ s12916-014-0158-6Xiao Q1, Murphy RA, Houston DK, Harris TB, Chow WH, Park Y. Dietary and supplemental calcium intake and cardiovascular disease mortality: the National Institutes of Health-AARP diet and health study. JAMA Intern Med. 2013 Apr 22;173(8):639-46. doi: 10.1001/ jamainternmed.2013.3283.Xiao Q1, Murphy RA, Houston DK, Harris TB, Chow WH, Park Y. Dietary and supplemental calcium intake and cardiovascular disease mortality: the National Institutes of Health-AARP diet and health study. JAMA Intern Med. 2013 Apr 22;173(8):639-46. doi: 10.1001/ jamainternmed.2013.3283.Simon KO1, Nutt EM, Abraham DG, Rodan GA, Duong LT. The alphavbeta3 integrin regulates alpha5beta1-mediated cell migration toward fibronectin. J Biol Chem. 1997 Nov 14;272(46):29380-9.Simon KO1, Nutt EM, Abraham DG, Rodan GA, Duong LT. The alphavbeta3 integrin regulates alpha5beta1-mediated cell migration toward fibronectin. J Biol Chem. 1997 Nov 14;272(46):29380-9.Reginster JY1, Lecart MP, Richy F. Importance of alfacalcidol in clinical conditions characterized by high rate of bone loss. J Rheumatol Suppl. 2005 Sep;76:21-5.Reginster JY1, Lecart MP, Richy F. Importance of alfacalcidol in clinical conditions characterized by high rate of bone loss. J Rheumatol Suppl. 2005 Sep;76:21-5.Richy F1, Ethgen O, Bruyere O, Reginster JY. Efficacy of alphacalcidol and calcitriol in primary and corticosteroid-induced osteoporosis: a meta-analysis of their effects on bone mineral density and fracture rate. Osteoporos Int. 2004 Apr; 15(4):301-10. Epub 2004 Jan 22.Richy F1, Ethgen O, Bruyere O, Reginster JY. Efficacy of alphacalcidol and calcitriol in primary and corticosteroid-induced osteoporosis: a meta-analysis of their effects on bone mineral density and fracture rate. Osteoporos Int. 2004 Apr; 15(4):301-10. Epub 2004 Jan 22.

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