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Prediction of Bone Mass Density Variation by Bone Remodeling Markers in Postmenopausal Women with Vitamin D Insufficiency Treated with Calcium and Vitamin D Supplementation

Departments of Rheumatology and Biochemistry (F.G., M.B., S.K., J.-L.S., P.F.), and Laboratory of Clinical Pharmacy, Faculty of Pharmacy (M.B., S.K.), CHU, Amiens 80054, France; Laboratoires Innothera (M.Mat., N.H., M.Maa.), Arcueil 94111, France; and UPR 1524, Hôpital Saint Vincent de Paul (M.G.), Paris 75010, France

Address all correspondence and requests for reprints to: Prof. P. Fardellone, Service de Rhumatologie, Hôpital Nord, Amiens 80054 Cedex 1, France. E-mail: fardellone.patrice{at}chu-amiens.fr.

The aim of this study was to determine whether early changes in bone markers could predict long-term response in bone mineral density (BMD) after calcium (500 mg) and vitamin D (400 IU) supplementation twice daily in ambulatory elderly women with vitamin D insufficiency (25-hydroxyvitamin D, <12 ng/ml). One hundred and ninety-two women (mean age, 75 ± 7 yr) were randomized to receive either the supplementation (n = 95) or a placebo (n = 97) in a double-blind, controlled clinical trial for 1 yr. In comparison with the placebo group, supplementation significantly increased BMD, normalized 25-hydroxyvitamin D and significantly decreased intact PTH and bone remodeling markers. The initial values of telopeptide cross-links were correlated with improvement in total body BMD [urinary N-telopeptides (NTX), r = 0.38; C-telopeptides (CTX), r = 0.32; serum CTX, r = 0.28], and the 3-month changes in the same markers were correlated with improvement in total body (urinary N-telopeptides, r = -0.29; serum CTX, r = -0.26) and vertebral BMD (CTX, r = -0.26; all P < 0.05). We concluded that short-term changes in bone resorption markers can predict long-term variations in BMD in elderly women with vitamin D insufficiency receiving calcium and vitamin D supplementation.

This work was supported by the Laboratoires Innothera.

Abbreviations: b-AP, Bone alkaline phosphatase; BMD, bone mineral density; Ca, calcium; Ca-Vit D, calcium and vitamin D group; Cr, creatinine; CTX, C-terminal telopeptide of type I collagen; f-DPD, free deoxypyridinoline; i-PTH, intact PTH; 25(OH)D, 25-hydroxyvitamin D; NTX, N-terminal telopeptide of type I collagen; P, placebo group; s-, serum; u-, urinary.

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