Resolution of Vitamin D Insufficiency in Osteopenic Patients Results in Rapid Recovery of Bone Mineral Density

• Published in: The journal of clinical endocrinology and metabolism Vol. 84; no. 8; pp. 2729 - 2730
• Main Authors: Adams, John S, Kantorovich, Vitaly, Wu, Cindy, Javanbakht, Marjan, Hollis, Bruce W
• Format: Journal Article
• Language: English
• Published: Washington Oxford University Press 01.08.1999
• Subjects: 25-Hydroxyvitamin D; Bone density; Bone loss; Bone mass; Bone mineral density; Calcium (urinary); Creatinine; Hyperparathyroidism; Osteocalcin; Osteopenia; Osteoporosis; Parathyroid hormone; Spine (lumbar); Vitamin D; Vitamin D2
• DOI: 10.1210/jcem.84.8.5899
• ISSN: 0021-972X

Vitamin D insufficiency is characterized biochemically by the presence of secondary hyperparathyroidism, which can contribute to bone loss in osteopenic patients. Over a 2-yr period of evaluation of 118 consecutive, free living patients with osteopenia or osteoporosis, we identified 18 subjects with depressed serum 25-hydroxyvitamin D (25OHD;≤ 14 ng/mL). Twelve of these subjects harbored a low 25OHD level and consented to undergo replacement with 50,000 IU vitamin D2 twice weekly for 5 weeks. Five hundred thousand units of oral vitamin D2 resulted in significant increases in 25OHD (+24.3± 16.9 ng/mL; P < 0.001) and the fasting urinary calcium/creatinine excretion ratio (+0.06 ± 0.004; P = 0.01) and significant decreases in the serum concentration of PTH (−32.9 ± 36.9 pg/mL; P< 0.001) and osteocalcin (−4.9 ± 2.4 ng/mL; P < 0.001). Vitamin D repletion was associated with a significant 4–5% annualized increase in bone mineral density at both the lumbar spine (P < 0.001) and the femoral neck (P = 0.03), indicating that resolution of vitamin D insufficiency in a population of patients with low bone mass results in a rapid rebound increase in bone mineral density.