Effect of a vitamin D analog on leg bone mineral density in patients with chronic spinal cord injury.
A randomized, placebo-controlled trial was performed to determine the effect of a vitamin D analog (1-alpha-hydroxyvitamin D(2) [1-alpha D(2)]) on the bone mineral density (BMD) in patients with chronic spinal cord injury (SCI). Forty subjects with chronic complete motor SCI were enrolled. The mean plus or minus standard deviation age and duration of injury were 42 plus or minus 12 yr and 11 plus or minus 10 yr, respectively. Either 4 micrograms 1-alpha D(2) (n = 19) or placebo (n = 21) was administered daily for 24 mo. Metabolic markers of bone resorption and formation were obtained. Regional lower-limb dual-energy x-ray absorptiometry was performed at baseline and at 6, 12, 18, and 24 mo. Leg BMD and percent change from baseline significantly increased at 6 (percent change only), 12, 18, and 24 mo in the treatment group, but not in the placebo group. Urinary N-telopeptide, a marker of bone resorption, was significantly reduced during treatment with 1-alpha D(2), but markers of bone formation were not changed.
Bauman
William A
WA
Department of Veterans Affairs (VA) Rehabilitation Research and Development Center of Excellence, VA Medical Center, Bronx, NY 10468, USA. wabauman@earthlink.net
Spungen
Ann M
AM
Morrison
Nancy
N
Zhang
Run-Lin
RL
Schwartz
Ernest
E
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002762:Cholecalciferol / Q000627:therapeutic use*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004872:Ergocalciferols / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy* / Q000209:etiology; D010264:Paraplegia / Q000150:complications; D011336:Probability; D011782:Quadriplegia / Q000150:complications; D012016:Reference Values; D013119:Spinal Cord Injuries / Q000150:complications*; D016896:Treatment Outcome
D050071:Bone Density Conservation Agents; D004872:Ergocalciferols; D002762:Cholecalciferol