Endocrinology and Metabolism

Original Articles

The Effects of Combined Treatment of Alendronate Plus Active or Plain Vitamin D on the Vitamin D Metabolism and Bone Turnover Markers in Patients with Osteoporosis.: Jee Hoon Koo, Hyun Kyung Kim, In Sung Kim, Eun Kyung Kim, Yoon Sok Chung; Endocrinol Metab. 2010;25(4):305-309. Published online December 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.4.305

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BACKGROUND
The purpose of this study was to evaluate the effects of combined treatment with alendronate plus active or plain vitamin D on the vitamin D metabolism and bone turnover markers in patients with osteoporosis. METHODS: We investigated 297 osteoporosis outpatients who were treated with Maxmarvil(R) (alendronate 5 mg plus calcitriol 0.5 microg) daily or Fosamax Plus(R) (alendronate 70 mg plus cholecalciferol 2,800 IU) weekly for 1 year. The serum levels of 25(OH)D, parathyroid hormone (PTH), calcium, phosphorus, osteocalcin and N-telopeptide were measured at baseline and after 3, 6, and 12 months of treatment. RESULTS: The data of 72 of the 297 patients were analyzed. In the Maxmarvil(R) group (n = 45), the serum PTH significantly decreased by 17% from baseline at 6 months (microd = -6.10; +/- 0.85 SE; P < 0.05) and it remained suppressed to 12 months. The serum 25(OH)D tended to increase, but without significance. In the Fosamax Plus(R) group (n = 27), the serum 25(OH)D significantly increased by 77% from baseline at 3 months (microd = 9.87; +/- 2.32 SE; P < 0.05) and it remained significantly higher than baseline at 6 months (microd = 3.49; +/- 0.86 SE; P < 0.05) and 12 months (microd = 10.47; +/- 0.71 SE; P < 0.001). However, the serum PTH showed no significant decrease. In the Maxmarvil(R) group, the serum osteocalcin significantly decreased by 26% from baseline at 12 months (microd = -5.15; +/- 0.35 SE; P < 0.05), and in the Fosamax Plus(R) group, the serum osteocalcin significantly decreased by 19% from baseline at 6months (microd = -2.64; +/- 0.73 SE; P < 0.05) and it remained suppressed to 12 months (microd = -2.99; +/- 0.37 SE; P = 0.32) without significance. CONCLUSION: Maxmarvil(R) and Fosamax Plus(R) both improved the bone metabolism in Korean osteoporosis patients. Maxmarvil(R) significantly lowered the serum PTH levels, whereas Fosamax Plus(R) significantly elevated the serum 25(OH)D levels.

Citations

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Efficacy and Safety of Weekly Alendronate Plus Vitamin D35600 IU versus Weekly Alendronate Alone in Korean Osteoporotic Women: 16-Week Randomized Trial
Kwang Joon Kim, Yong-Ki Min, Jung-Min Koh, Yoon-Sok Chung, Kyoung Min Kim, Dong-Won Byun, In Joo Kim, Mikyung Kim, Sung-Soo Kim, Kyung Wan Min, Ki Ok Han, Hyoung Moo Park, Chan Soo Shin, Sung Hee Choi, Jong Suk Park, Dong Jin Chung, Ji Oh Mok, Hong Sun Ba
Yonsei Medical Journal.2014; 55(3): 715. CrossRef

Adverse Effects of Antiepileptic Drugs on Bone Mineral Density in Women with Epilepsy.: Yong Won Cho, In Kyu Lee, Seung Ho Hur; J Korean Endocr Soc. 2002;17(2):218-225. Published online April 1, 2002

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Abstract PDF: BACKGROUND
Osteoporosis or osteopenia has been reported in patients taking antiepileptic drugs, but the precise pathophysiological mechanisms of these abnormalities are unclear. The aim of this study was to assess the relationship of antiepileptic drugs on bone mass by analyzing bone mineral density (BMD). METHODS: We compared 62 epileptic women on long-term antiepileptic therapy the same number of age and weight matched healthy control subjects. We measured the serum calcium, phosphorus, protein, alkaline phosphatase and osteocalcin for analyzing factors, that have an influence on bone metabolism and BMD. BMD was measured on the lumbar spine by dual-energy X-ray absorptiometry. RESULTS: The serum level of calcium and osteocalcin were not different between the groups. The serum level of phosphorus and protein were significantly lower in the patient group compared to their controls. The serum level of alkaline phosphatase was significantly higher in the patient group than in their controls. The BMD was significantly lower in the patient group than in their controls. There was a significant correlation between the BMD and the duration of therapy in the patient group. CONCLUSION: The long-term use of antiepileptic drugs leads to a decreased BMD, and the degree of bone mineral density was related to the duration of the therapeutic use of antiepileptics.

The Effects of Type 1 diabetes on the Metabolism and Density of Bone in Children.: Sang Jun Lee, Dong Wook Lee, Hyun Dae Yoon, Kyu Chang Won, Hyoung Woo Lee, Yoon Jung Cho, Heung Sik Kim, Seung Beom Han, In Kyu Lee, Hee Ja Lee; J Korean Endocr Soc. 2000;15(4-5):582-590. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The effects of type 1 diabetes mellitus on the metabolism and density of bone in children are still controversial. The aim of this study was to evaluate the effects of type 1 diabetes on markers of bone metaboism and BMD in children by analyzing BMI, HbA1c, biochemical markers, sex hormones, bone metabolism and BMD related factors. MRTHODS: We compared 36 patients (15 males, 21 females) with type 1 diabetes mellitus to 167 healthy children (84 males, 83 females) who lived in Taegu. We measured FBS, serum calcium, phosphorus, HbA1c, osteocalcin, testosterone and estradiol for analyzing the factors which influence on bone metabolism and BMD. BMD was measured at lumbar spine, femur and total body by DEXA. RESULTS: The BMI and serum level of osteocalcin were not different in both groups. Serum calcium level was significantly lower in the diabetic group than that of control group. BMD had no difference in both groups. There was no correlation between BMD and glycemic control (HbA1c) or duration of diabetes. There was good correlation (r=0.78, p<0.01) between serum testosterone level and BMD in male patient group. There was negative correlation (r=-0.4) between serum osteocalcin level and BMD. There was significant correlation (male: r=0.76, female: r=0.66) between lean body mass and BMD in both group. CONCLUSION: The BMD was not decreased significantly and bone turn-over was normal in children with noncomplicated type 1 diabetes mellitus, and BMD was not influenced by the duration or degree of metabolic control of diabetes. But, we need further study including other risk factors that have influences on BMD and bone metabolism in type 1 diabetes mellitu.

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