Biochemical effects of calcium and vitamin D supplementation in elderly, institutionalized, vitamin D-deficient patients.
Forty-five subjects (41 women and 4 men) in long-stay and medium-stay facilities, aged 74 to 95 years (mean 86.4 years), with 25-hydroxy-vitamin D levels less than 12 ng/ml, were treated for six consecutive months with two tablets per day of a preparation containing vitamin D3 (800 IU/day) and calcium carbonate (1 g elemental calcium/day). Serum levels of 25-hydroxy-vitamin D were very low at baseline (5.6 +/- 0.4 ng/ml) and rose significantly under treatment, to normal values, 33.2 +/- 1.2 and 40.9 +/- 2.1 ng/ml after three and six months, respectively (p < 0.001 for both comparisons). Serum calcium increased significantly, by 4.5% (p < 0.001) during the first three months, and remained at a plateau thereafter. Corrected serum calcium rose by 8.9% (p < 0.001) during the trial. No patient developed hypercalcemia. Serum parathyroid hormone levels, which were elevated at baseline (71.6 +/- 5.8 pg/ml; normal, 12 to 54 pg/ml), decreased gradually and significantly throughout the treatment period, by 43.0% and 67.1% after three and six months, respectively (p < 0.001 for both comparisons). Serum alkaline phosphatase activity fell concomitantly, by 9.9% after three months (p < 0.01) and 36.5% after six months (p < 0.001). In conclusion, the preparation used in our study is effective in correcting both the vitamin D deficiency that is prevalent in elderly institutionalized patients and the resultant increase in bone turnover.
Chapuy
M C
MC
National Institute for Health and Medical Research (INSERM) unit 403, Edouard Herriot Hospital, Lyon, France.
Chapuy
P
P
Thomas
J L
JL
Hazard
M C
MC
Meunier
P J
PJ
D000284:Administration, Oral; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D002118:Calcium / Q000097:blood; D002119:Calcium Carbonate / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy / Q000209:etiology; D006996:Hypocalcemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007326:Institutionalization; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D012189:Retrospective Studies; D014807:Vitamin D / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000188:drug therapy*
D010281:Parathyroid Hormone; D014807:Vitamin D; D000469:Alkaline Phosphatase; D002119:Calcium Carbonate; D002118:Calcium