长期使用活性维生素D安全性的相关性研究

目的 对连续和间断服用活性维生素D治疗6个月的骨质疏松症者,测24 h尿钙定量比较,了解长期使用活性维生素D的安全性.方法 采用美国GE公司生产的Luner Prodigy Advance型骨密度仪测定骨密度确定为骨质疏松者106例.56例患者连续服用活性维生素D6个月为治疗组,50例患者间断服用活性维生素D6个月为对照组.采用美国强生VIPRO 250仪器干化学法测定24 h尿钙定量.采用德国罗氏MODULAR PPISE 900仪器酶速率法测定血液生化指标.结果 治疗组与对照组相比,差异无显著性(P＞0.05).结论 肝肾功能正常的骨质疏松患者,生理剂量内活性维生素D连续服用6个月,对机体是安全的.     

钙剂、活性维生素D3对十堰地区低骨量人群的干预

目的 应用钙剂、活性维生素D3对低骨量人群进行干预治疗,观察其对BMD、BGP、DPD及预防骨质疏松的作用.方法 选取骨量减少患者100例,随机分成对照组和治疗组,每组50例,对照组服用乐力(2g/d),治疗组服用乐力(2g/d)和阿法迪三(0.5μg/d),连续治疗12个月.在治疗前、治疗后6月和12月检测BMD、BGP、DPD.结果 两组经治疗后BMD、BGP均较治疗前增加(P<0.05),DPD下降(P<0.05),以治疗组差异更为明显,组间比较有统计学意义(P<0.05).结论 骨量减少应早期干预治疗,钙剂与活性维生素D联合应用可以更有效地预防及延缓骨质疏松的发生.     

二膦酸盐联合维生素D治疗糖皮质激素性骨质疏松和骨量减少的初步观察

目的：观察联合维生素D和第三代二膦酸盐对糖皮质激素长期应用所造成的骨量丢失肾炎患者的疗效。方法：15例来自本院经定量CT（QCT）诊断为糖皮质激素性骨质疏松和骨量减少病情稳定肾炎患者,服用钙尔奇1片/d和福善美70mg/周,观察入选时及治疗6月后临床症状和空腹血钙、磷、甲状旁腺激素、碱性磷酸酶、24h尿钙、磷和定量CT腰椎骨密度值变化。结果：疼痛症状改善总有效率（显效加有效）为53.3%。治疗6个月前后血钙、磷、甲状旁腺激素、碱性磷酸酶、24h尿钙、磷变化,无统计学意义（P〉0.05）,腰椎骨密度差值为（11.8±5.3）mg/cm^3,经检验有统计学意义（P〈0.01）。结论：维生素D联合二膦酸盐能有效改善糖皮质激素长期应用所造成的骨量丢失,增加骨密度,改善疼痛,有利于最大程度的预防骨质疏松骨折,但是否优于传统单纯钙和维生素D治疗有待进一步对照研究。     

钙剂、活性维生素D3对十堰地区低骨量人群的干预

目的应用钙剂、活性维生素D3对低骨量人群进行干预治疗,观察其对BMD、BGP、DPD及预防骨质疏松的作用。方法选取骨量减少患者100例,随机分成对照组和治疗组,每组50例,对照组服用乐力(2g/d),治疗组服用乐力(2g/d)和阿法迪三(0.5μg/d),连续治疗12个月。在治疗前、治疗后6月和12月检测BMD、BGP、DPD。结果两组经治疗后BMD、BGP均较治疗前增加(P<0.05),DPD下降(P<0.05),以治疗组差异更为明显,组间比较有统计学意义(P<0.05)。结论骨量减少应早期干预治疗,钙剂与活性维生素D联合应用可以更有效地预防及延缓骨质疏松的发生。     

老年骨质疏松症股骨颈骨折术后抗骨质疏松治疗的初步观察

目的探讨老年人骨质疏松症股骨颈骨折术后应用（密盖息＋钙＋维生素D3）方案抗骨质疏松治疗的效果。方法随机选择诊断为“原发性骨质疏松症＋股骨颈病理性骨折”的老年患者56例,人工关节置换术后除髋关节康复锻炼外,应用（密盖息＋钙＋维生素D3）方案治疗3个月,比较治疗前后临床症状和空腹血钙、磷、甲状旁腺激素、碱性磷酸酶、24h尿钙、磷以及定量CT腰椎骨密度值变化。结果周身疼痛症状改善有效率为50％;治疗3个月前、后空腹血钙、磷、甲状旁腺激素、碱性磷酸酶、24h尿钙、磷变化间的差异无统计学意义（P〉0．05）;腰椎骨密度值间的差异有统计学意义（P〈0．01）。结论老年人股骨颈骨折术后应用（密盖息＋钙＋维生素D3）方案抗骨质疏松治疗能有效增加骨密度,改善疼痛,从而预防再次骨折。     

补充双歧杆菌四联活菌片对糖尿病性骨质疏松患者骨代谢指标影响的研究

目的通过观察2型糖尿病性骨质疏松患者补充双歧杆菌四联活菌片后骨代谢指标的变化,探讨补充益生菌是否能改善骨代谢标志物及骨密度。方法选取2016年1月至2017年12月在我院内分泌科门诊检查或住院的2型糖尿病性骨质疏松患者200例,随机分为对照组(100名)与实验组(100名)。对照组患者采取常规补充钙剂及维生素D治疗;实验组患者在给予补充钙剂及维生素D治疗基础上加用双歧杆菌四联活菌片治疗。于治疗后3个月、6个月、12个月后观察患者骨钙素、尿钙肌酐比、总1型胶原氨基端延长肽、维生素D和骨密度(12个月测1次)的变化。结果补充双歧杆菌四联活菌后骨钙素水平明显升高,骨密度明显升高,差异有统计学意义。补充维生素D后维生素D水平明显升高,差异有统计学意义。结论补充双歧杆菌四联活菌片后,通过升高2型糖尿病性骨质疏松患者的骨钙素水平改善了骨密度。     

云克治疗绝经后骨质疏松93例临床观察

目的评价云克治疗绝经后骨质疏松症的疗效。方法 93例绝经后骨质疏松症患者随机分为治疗组58例和对照组35例。治疗组采用云克注射治疗和服用维生素D制剂,10～15d为1个疗程,连续三个疗程;对照组常规口服钙剂。分别观察2组治疗前及治疗后3、6、12个月血中骨钙素(BGP)、骨特异性碱性磷酸酶(BALP)及骨密度(BMD)变化。结果治疗组治疗3个月后BGP值开始下降,而BALP则在治疗后6个月逐渐降低,BMD值在治疗后12个月较治疗前增加,与对照组比较差异均有统计学意义(P<0.05);对照组治疗前后3项指标均无差异。结论云克对骨组织具有明显的导向性,抑制破骨细胞活性,抑制骨丢失,增加骨强度,对绝经后骨质疏松有较好疗效。     

静脉注射双膦酸盐治疗更年期骨质疏松症疗效分析

目的 探讨双膦酸盐(艾本)治疗老年骨质疏松症的临床疗效。方法 选择60例更年期骨质疏松症患者随机分为对照组及实验组,实验组应用二膦酸盐2mg每三个月一次静滴,同时口服活性维生素D和钙剂,对照组给予平衡盐溶液每三个月一次,同时口服活性维生素D和钙剂。分别于治疗前和治疗后3个月、6个月、9个月、12个月进行骨密度测量。结果 治疗后3个月和6个月骨密度增加不明显,治疗9个月和12个月后骨密度显著升高,与对照组有显著性差异(P＜0.01)。结论 使用二膦酸盐治疗骨质疏松,能在一定程度上抑制骨丢失,增加骨密度,治疗骨质疏松,改善老年骨质疏松患者的生活质量。     

99Tc-MDP联合钙剂、活性维生素D3治疗甲亢继发骨质疏松症的疗效评价

目的 评价99Tc-MDP治疗甲亢继发骨质疏松症的疗效。方法 将89例甲亢继发骨质疏松患者按治疗方法分为联合治疗组（A组 42例）和对照组（B组 47例）,两组均采用131I治疗甲亢,联合治疗组采用常规口服钙剂加活性维生素D3治疗,同时加用99Tc-MDP注射治疗,10d为1个疗程,连续3个疗程,每疗程之间间隔3~4w; 对照组常规口服钙剂加维生素D3治疗。分别观察 2 组治疗前及治疗后 3、6、12 个月骨密度( BMD) 、血清骨钙素( BGP) 、骨碱性磷酸酶( B-ALP) 以及甲状腺功能各项指标( FT3、FT4、TSH) 的变化。结果 （1）131I治疗6个月后联合治疗组BGP、B-ALP开始下降,治疗前后比较差异有统计学意义（P＜0.05）;（2）联合治疗组BMD值在治疗后 12 个月较治疗前增加,与对照组比较差异有统计学意义( P＜0. 05);(3)治疗3、6、12个月后两组间甲状腺功能指标变化无差异（P>0.05）;（4）联合治疗组与对照组总有效率分别为92.8%,76.6%,联合治疗组优于对照组,差异有统计学意义（P<0.05）。结论 99Tc-MDP与钙剂及活性维生素D3联用,对甲亢继发骨质疏松症有较好疗效,具有一定临床推广价值。     

术前尿钙排泄量对骨质疏松性椎体压缩性骨折患者术后骨折延迟愈合的影响

目的：探讨术前尿钙排泄量对骨质疏松性椎体压缩性骨折（OVCF）患者术后骨折延迟愈合的影响。方法：前瞻性选择2022年8月至2023年5月收治的OVCF患者作为研究对象,所有患者拟行经皮椎体成形术。术前测定24 h尿钙水平,计算24 h尿钙排泄量,术后随访3个月,根据骨折愈合情况将患者分为延迟组与非延迟组。比较两组患者基线资料、骨密度T值和术前24 h尿钙、24 h尿钙排泄量,采用Pearson相关性检验分析术前24 h尿钙、24 h尿钙排泄量与骨密度T值的相关性,采用logistic回归分析检验骨密度T值和术前24 h尿钙、24 h尿钙排泄量对术后骨折延迟愈合的影响,绘制受试者操作特征（ROC）曲线分析术前24 h尿钙、24 h尿钙排泄量对术后骨折延迟愈合的预测价值。结果：共纳入185例OVCF患者作为研究对象,男31例,女154例;年龄57～73岁,平均（65.2±3.6）岁;术后均随访3个月,185例患者中发生骨折延迟愈合的32例作为延迟组,延迟愈合率为17.3%。延迟组患者骨密度T值低于非延迟组,术前24 h尿钙、24 h尿钙排泄量高于非延迟组,差异有统计学意义（P<0.0...     

Intestinal hyperabsorption of calcium and low bone turnover in hypercalciuric postmenopausal osteoporosis

Hypercalciuria of intestinal origin has been linked with bone loss in calcium nephrolithiasis and idiopathic osteoporosis. This retrospective data analysis was performed to explore potential pathogenetic link between intestinal hyperabsorption of calcium and postmenopausal osteoporosis. Data were retrieved from postmenopausal women who were evaluated for osteoporosis or osteopenia at the Mineral Metabolism Clinic of UT Southwestern Medical Center. A total of 319 patients underwent the test of calciuric response to oral calcium load to obtain an indirect measure of intestinal calcium absorption. Serum and urinary biochemistry and L2–L4 bone mineral density (BMD) were compared between five quintiles of calciuric response. There was a statistically significant trend toward a rise in 24-h urinary calcium and a decrease in urinary deoxypyridinoline (DPD) and BMD, with increasing order of quintiles. The presentation of those in the 1st quintile was consistent with vitamin D insufficiency or deficiency, with impaired calcium absorption, secondary hyperparathyroidism, and stimulated bone turnover (high normal urinary DPD). In contrast, patients in the 5th quintile displayed a picture of absorptive hypercalciuria of stone disease, with intestinal hyperabsorption of calcium, high or high normal urinary calcium and suppressed bone turnover (low or low normal urinary DPD). Thus, the assessment of intestinal calcium absorption in a seemingly homogeneous group of postmenopausal women with osteoporosis or osteopenia revealed a spectrum of calciuric response whose extremes may represent two physiologically distinct subtypes that have important diagnostic and therapeutic implications.     

Acute Effects of Calcitonin Nasal Spray on Serum C-telopeptide of Type 1 Collagen (CTx) Levels in Elderly Osteopenic Women with Increased Bone Turnover

Salmon calcitonin is a potent inhibitor of osteoclastic activity. The effect of calcitonin in elderly women with high bone turnover at higher risk of developing osteoporosis has not been studied. To investigate acute effects of calcitonin treatment on bone resorption markers in elderly women, we conducted a randomized trial in women >65 years of age with high bone turnover assessed as urinary N-telopeptide of type-I collagen (NTx) levels 1 SD higher than mean premenopausal levels, which was irrespective of bone density. A total of 98 elderly women were randomly assigned to receive either 200 IU calcitonin nasal spray (n = 75) with calcium (500 mg) and vitamin D (200 IU) or calcium and vitamin D (n = 23) alone for 6 months. Blood and urine samples were collected at 0, 2, 4, and 6 months and analyzed for urinary NTx and serum C-telopeptide of type-1 collagen (CTx). At baseline, mean age was 72.1 ± 4.7 (mean ± SD) in the calcitonin group and 72.2 ± 6 years in the control group. The spine and total hip BMD, serum PTH levels and urinary calcium/creatinine ratios were similar in both groups. Mean BMD was in the osteopenic range in both groups. Calcitonin treatment resulted in significant decreases in serum CTx levels, 2, 4 and 6 months after treatment as compared to baseline, and after 4 and 6 months as compared to controls. A maximum decrease from baseline of 33% was seen at 6 months. The urinary resorption marker, urine NTx, showed a significant decrease in the calcitonin group when compared to baseline only at the 6-month time point. Analysis of least significance change (LSC) showed that 70% of calcitonin patients were categorized as responders using serum CTx after 6 months of treatment. We conclude that 200 IU calcitonin effectively decreases bone resorption within 60 days of therapy, thus preventing further bone loss in elderly women who are at a high risk of developing osteoporosis.     

A randomized controlled trial of vitamin D supplementation on preventing postmenopausal bone loss and modifying bone metabolism using identical twin pairs.

Vitamin D supplementation, when given with calcium, has been shown to increase bone mineral density (BMD) and reduce the incidence of hip fracture in elderly subjects. Despite its widespread use, the benefits of vitamin D supplementation in younger women and as a single agent are less clear. We performed a randomized co-twin, placebo-controlled, double-blind trial over 2 years to measure the effect of vitamin D3 supplementation on bone density and bone metabolism in young postmenopausal women. Seventy-nine monozygotic (MZ) twin pairs (mean age, 58.7 years; range, 47-70 years) were recruited. For each twin pair, one was randomized to 800 IU cholecalciferol/day for 2 years and the other was randomized to placebo. BMD was measured at the spine and hip and heel ultrasound at baseline, 12, 18, and 24 months. Samples were collected at 0, 3, and 6 months to measure serum calcium, 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), osteocalcin, and urinary deoxypyridinoline (DPD). In total, 64 pairs completed the study. No differences in baseline characteristics were seen between the groups. At 6 months, the treatment group had an increase in serum vitamin D [mean +/- SEM intrapair difference, 14.1+/-2.4 microg/liter (p < 0.001)]. There were no significant differences in other serum measurements or bone markers at 3 months or 6 months. At 24 months, no significant treatment effect was seen on BMD or calcaneal ultrasound change within pairs. Subanalysis of treatment response by vitamin D receptor (VDR) genotype revealed no significant difference in effect on BMD variables with treatment. On the basis of these results, vitamin D supplementation, on its own, cannot be recommended routinely as an osteoporosis prevention for healthy postmenopausal women with normal vitamin D levels under the age of 70 years.     

Osteoporosis treatment in postmenopausal women after peripheral fractures: impact of information to general practitioners

A low-impact fracture in a postmenopausal woman should prompt investigations for osteoporosis followed, if needed, by appropriate treatment. OBJECTIVES: To evaluate the impact of information alerting general practitioners to the need for osteoporosis treatment in postmenopausal women with a recent history of peripheral fracture. METHODS: We conducted a prospective 7-month follow-up study of 78 postmenopausal women, with a mean age of 81.5 years, admitted to the emergency department for peripheral fractures. Three months after the fracture, we sent a letter to the general practitioner of each patient emphasizing the probable contribution of osteoporosis to the fracture and the need for osteoporosis treatment. Six months after the fracture, we interviewed the patients by telephone, and one month later we mailed a questionnaire to those physicians who had not followed the treatment recommendation. RESULTS: At emergency room admission, 9 patients were receiving treatment for osteoporosis (hormone replacement therapy in one patient and calcium and vitamin D supplementation in eight patients). Admission to a ward was required in 66 (85%) patients. No treatment for osteoporosis was given at discharge. Six months after discharge, seven patients reported recent initiation of calcium and vitamin D supplementation, and none reported other osteoporosis treatments. The response rate to the physician questionnaire mailed 7 months after discharge was 54% (n=28); responses showed treatment of 11 additional patients, by calcium and vitamin D supplementation in six cases and by bisphosphonates with or without calcium and vitamin D supplementation in five cases. Treatment initiation rates were similar in patients younger and older than 80 years. CONCLUSIONS: Despite information of general practitioners about the need for osteoporosis treatment, such treatment was initiated in only 30.5% of patients. General practitioners may be reluctant to initiate osteoporosis treatment in patients who are very old or have multiple comorbidities.     

Prophylaxis against bone loss in Kock reservoir patients with reduced glomerular filtration rate

OBJECTIVE: We investigated whether treatment with calcium carbonate and vitamin D3 can improve the bone mineral content of patients with ileal reservoirs for continent urinary diversion and a reduced glomerular filtration rate (GFR). MATERIAL AND METHODS: Twenty-six patients with Kock reservoirs were included in the study. Bone mineralization was determined using dual-energy X-ray absorptiometry. Kidney function was estimated from Cr-EDTA clearance and serum cystatin C concentration. Osteocalcin and parathyroid hormone in serum were also measured. Patients with reduced GFR were treated with calcium carbonate and vitamin D3 perorally. RESULTS: Bone mineral density in the femur neck and hip increased in the treatment group, as reflected by an improved T score. CONCLUSION: Patients with ileal reservoirs for continent urinary diversion and reduced kidney function should be supplemented with calcium carbonate and vitamin D3 in order to reduce the long-term risk of osteoporosis.     

Vitamin K2 (menatetrenone) effectively prevents fractures and sustains lumbar bone mineral density in osteoporosis.

We attempted to investigate whether vitamin K2 (menatetrenone) treatment effectively prevents the incidence of new fractures in osteoporosis. A total of 241 osteoporotic patients were enrolled in a 24-month randomized open label study. The control group (without treatment; n = 121) and the vitamin K2-treated group (n = 120), which received 45 mg/day orally vitamin K2, were followed for lumbar bone mineral density (LBMD; measured by dual-energy X-ray absorptiometry [DXA]) and occurrence of new clinical fractures. Serum level of Glu-osteocalcin (Glu-OC) and menaquinone-4 levels were measured at the end of the follow-up period. Serum level of OC and urinary excretion of deoxypyridinoline (DPD) were measured before and after the treatment. The background data of these two groups were identical. The incidence of clinical fractures during the 2 years of treatment in the control was higher than the vitamin K2-treated group (chi2 = 10.935; p = 0.0273). The percentages of change from the initial value of LBMD at 6, 12, and 24 months after the initiation of the study were -1.8 +/- 0.6%, -2.4 +/- 0.7%, and -3.3 +/- 0.8% for the control group, and 1.4 +/- 0.7%, -0.1 +/- 0.6%, and -0.5 +/- 1.0% for the vitamin K2-treated group, respectively. The changes in LBMD at each time point were significantly different between the control and the treated group (p = 0.0010 for 6 months, p = 0.0153 for 12 months, and p = 0.0339 for 24 months). The serum levels of Glu-OC at the end of the observation period in the control and the treated group were 3.0 +/- 0.3 ng/ml and 1.6 +/- 0.1 ng/ml, respectively (p < 0.0001), while the serum level of OC measured by the conventional radioimmunoassay (RIA) showed a significant rise (42.4 +/-6.9% from the basal value) in the treated group at 24 months (18.2 +/- 6.1% for the controls;p = 0.0081). There was no significant change in urinary DPD excretion in the treated group. These findings suggest that vitamin K2 treatment effectively prevents the occurrence of new fractures, although the vitamin K2-treated group failed to increase in LBMD. Furthermore, vitamin K2 treatment enhances gamma-carboxylation of the OC molecule.     

Vitamin D repletion does not alter urinary calcium excretion in healthy postmenopausal women

OBJECTIVE

To evaluate, in a posthoc analysis of a previous study, whether vitamin D repletion in postmenopausal women with insufficient vitamin D increases urinary calcium excretion, as vitamin D therapy might contribute to hypercalciuria and calcium stones in susceptible individuals, and the effect of vitamin D on the risk of urolithiasis warrants attention.

SUBJECTS AND METHODS

We recruited 18 women at ≥5 years after menopause who had vitamin D insufficiency (serum 25(OH)‐vitamin D, 16–24 mg/dL). We excluded women with a history of urolithiasis and kidney disease. Women had one calcium absorption study when vitamin D‐insufficient, received vitamin D therapy, and completed a second calcium absorption study when vitamin D‐replete. We fed subjects meals that mirrored the nutrient composition from self‐reported 7‐day diet diaries. To measure calcium absorption, we collected urine for 24 h during both visits.

RESULTS

We achieved vitamin D repletion in all women (25(OH)‐vitamin D before and after treatment, 22 and 63 mg/dL, respectively; P < 0.001). The mean calcium intake was 832 mg/day. Residual urine specimens were available for 16 women, allowing a measurement of 24‐h urinary calcium. Calcium excretion did not change after vitamin D therapy (212 before vs 195 mg/day after; P = 0.60). Of four women with hypercalciuria (>247 mg/day), calcium excretion decreased in three (377–312 mg/day, not significant).

CONCLUSION

Vitamin D supplementation did not increase the urinary calcium excretion in healthy postmenopausal women. Many stone formers are at risk of premature bone loss, vitamin D insufficiency, or both. Based on the present results we suggest a study of patients with hypercalciuria and nephrolithiasis to determine the risks of vitamin D therapy.     

牛奶与钙剂对老年人骨密度作用的8年临床观察

目的 观察牛奶与钙剂对老年人骨密度作用.方法 采用日本东芝公司制造的Xpress-GX螺旋CT(QCT),对本院老年职工进行第3腰椎骨密度(L3BMD)检测.选择L3BMD降低的82名(男性35,女性47)老年人,根据本人意愿(是否饮用牛奶和服用钙剂)分成观察组(n=43)和对照组(n=39),观察组(男性18,女性25),每人每日饮鲜牛奶250 ml～500 ml并日服含维生素D的钙剂(元素钙600～1200 mg、维生素D3 125～300 IU);对照组(男性17,女性22)未饮牛奶、未服钙剂,两组连续观察96个月为终点.在治疗前后分4个时间段(0、6、30、96个月)应用QCT检测参组老人L3BMD值,同时进行肝、肾功能、血清钙、尿钙及肝、胆、肾B超检查,并同步座谈访问,了解治疗后反应.结果 ①两组老人L3BMD均随增龄逐渐降低,其中,男女性观察组在长期钙奶干预下,自身配对比较L3BMD值,虽然逐次降低,但幅度很小;而男女性对照组的L3BMD逐年降低幅度明显增大,但无统计学意义(P>0.05).②两组间(观察组与对照组)分4个时间段成组比较L3BMD值,前3个时间段,对照组比观察组降低,但无明显差异(P>0.05),观察至第4个时间段(96个月)时,男女性对照组L3BMD比观察组明显降低,差异有显著性(P<0.05).结论 老年人长期饮用牛奶与含维生素D钙剂,能有效地延缓中轴骨BMD降低;长期钙奶干预对骨量增加能起到累积效应;对BMD降低而引起临床症状的老年人起到了重要辅助治疗作用;长时间应用钙剂未发现与之相关疾病发生.     

Postmenopausal osteoporosis. Digital Rx radiogrammetry in the diagnosis and follow-up of treatment with alfacalcidol

Postmenopausal osteoporosis is characterised by an increased resorption of trabecular bone, a consequence of estrogen deficit. Changes in vitamin D metabolism are also an important contributors to the development of osteoporosis in postmenopausal women. Vitamin D and its active metabolites (Alfacalcidol, Calcitriol) perform important functions in regulation of the calcium balance and the bone metabolism. Aim of our study was to determine the efficacy of Alfacalcidol (Alpha D3) in reducing the loss of bone mass. 391 postmenopausal women with osteopenia and 165 postmenopausal women with osteoporosis were treated 24 months with Alfacalcidol. The bone mineral density (BMD) was measured by Digital Rx Radiogrammetry (DXR). In osteopenic women treated with 0.5 mg Alfacalcidol, bone mineral density increased after 12 and 24 months with 3.4% and 2.3%. In osteoporotic women the increase of BMD was 1.8% and 2.4% after 12 and respectively 24 months. On the control group BMD decreased with 3.4% after 24 months. In our study Alfacalcidol confirmed the abolishment of the loss of bone mass.