Comparison of the effects of 1,25 dihydroxyvitamin D and 25 hydroxyvitamin D on bone pathology and disease activity in Crohn's disease patients.
BACKGROUND
Vitamin D is essential for osteopenia therapy in Crohn's disease (CD). The active form of vitamin-D (aVD) is the 1,25(OH)2D. There are no data available whether aVD or plain vitamin-D (pVD) has any advantage in managing osteoporosis in CD or has any effect on the activity of the disease itself. Our work is a prospective study to compare the effects of aVD and pVD on bone metabolism and the clinical course of CD.


METHODS
In all, 37 inactive CD patients were involved in the study and divided into 2 age-, gender-, and t-score-matched groups. Group A was treated with aVD while group B received pVD. Osteocalcin, beta-CrossLaps, osteoprotegerin, and receptor activator nuclear factor kappa-B ligand concentrations were estimated at the start of the study and at 6 weeks and 3 and 12 months. The activity of CD was also measured clinically and by laboratory parameters.


RESULTS
At week 6 the Crohn's Disease Activity Index (CDAI) scores and concentration of C-reactive protein decreased (69.44 +/- 58.6 versus 57.0 +/- 54.89 and 15.8 +/- 23.57 mmol/L versus 7.81 +/- 3.91 mmol/L, respectively, P < 0.05) parallel with markers of bone turnover (beta-CrossLaps: 0.46 +/- 0.21 ng/mL versus 0.40 +/- 0.25 ng/mL, and osteocalcin: 32.29 +/- 15.3 ng/mL versus 29.98 +/- 14.14 ng/mL, P < 0.05); however, osteoprotegerin concentration (marker of osteoblast activity) increased (3.96 +/- 2.1 pg/mL versus 4.58 +/- 2.19 pg/mL) in group A, but did not change in group B. Osteocalcin and beta-CrossLaps concentrations changed more significantly by the 3rd month; however, these changes disappeared by the 12th month.


CONCLUSIONS
According to our study, aVD has a more prominent short-term beneficial effect on bone metabolism and disease activity in CD compared with pVD.
Miheller
Pál
P
2nd Department of Medicine, Semmelweis University, Budapest, Hungary. mihpal@yahoo.co.uk
Muzes
Györgyi
G
Hritz
István
I
Lakatos
Gábor
G
Pregun
István
I
Lakatos
Péter László
PL
Herszényi
László
L
Tulassay
Zsolt
Z
D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D015519:Bone Density / Q000187:drug effects; D001842:Bone and Bones / Q000378:metabolism; D002118:Calcium / Q000097:blood / Q000652:urine; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D015675:Osteocalcin / Q000097:blood; D010024:Osteoporosis / Q000150:complications* / Q000188:drug therapy* / Q000378:metabolism; D053244:Osteoprotegerin / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood; D011446:Prospective Studies; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives*; D055815:Young Adult
D015415:Biomarkers; D053244:Osteoprotegerin; D010281:Parathyroid Hormone; C506030:TNFRSF11B protein, human; D015675:Osteocalcin; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium