title: The effect of cholecalciferol and calcitriol on biochemical bone markers in HIV type 1-infected males: results of a clinical trial.
abstract: HIV-1-infected patients have an increased risk of osteoporosis and fractures. The main objective of this study was to evaluate the bone metabolism in HIV-1-infected patients exposed to calcitriol and cholecalciferol. We also investigated the relationship between T cells and bone markers. We conducted a placebo-controlled randomized study running for 16 weeks including 61 HIV-1-infected males, of whom 51 completed the protocol. Nineteen participants were randomized to daily treatment with (A) 0.5-1.0 μg calcitriol and 1,200 IU (30 μg) cholecalciferol, 17 participants to (B) 1,200 IU cholecalciferol, and 15 participants to (C) placebo. At baseline and after 16 weeks, we determined collagen type 1 trimeric cross-linked peptide (CTx), procollagen type 1 N-terminal peptide (P1NP), parathyroid hormone (PTH), ionized calcium, 25-hydroxyvitamin D (25OHD), and 1,25-dihydroxyvitamin D [1,25(OH)2D]. We determined naive CD4(+) and CD8(+), activated CD4(+) and CD8(+), and regulatory CD4(+)CD25(+)CD127(low) T lymphocytes. Baseline levels of P1NP and CTx correlated (coefficient 0.5, p<0.001) with each other but not with PTH, 25OHD, or 1,25(OH)2D. In patients receiving calcitriol and cholecalciferol, the mean levels of P1NP (p<0.001) and CTx (p= 0.002) declined significantly compared to our placebo group. Based on changes in P1NP and CTx, we estimated that net bone formation occurred more frequently in group A compared to groups B and C. PTH correlated inversely with naive CD4(+) and CD8(+) cells. Otherwise, no relationships between bone markers and T lymphocytes were demonstrated. Supplementation with calcitriol and cholecalciferol induced biochemical indications of bone formation in HIV-1 patients.
authors.affiliation: Department of Endocrinology, Hvidovre Hospital, Copenhagen, Denmark. ulrichbangbang@gmail.com
authors.forename: Ulrich Christian
authors.initials: UC
authors.lastname: Bang
authors.forename: Lilian
authors.initials: L
authors.lastname: Kolte
authors.forename: Mette
authors.initials: M
authors.lastname: Hitz
authors.forename: Louise Lind
authors.initials: LL
authors.lastname: Schierbeck
authors.forename: Susanne Dam
authors.initials: SD
authors.lastname: Nielsen
authors.forename: Thomas
authors.initials: T
authors.lastname: Benfield
authors.forename: Jens-Erik Beck
authors.initials: JE
authors.lastname: Jensen
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D001842:Bone and Bones / Q000187:drug effects* / Q000378:metabolism*; D002117:Calcitriol / Q000008:administration & dosage*; D002118:Calcium / Q000097:blood; D002762:Cholecalciferol / Q000008:administration & dosage*; D024042:Collagen Type I / Q000097:blood; D004311:Double-Blind Method; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D010012:Osteogenesis / Q000187:drug effects; D010281:Parathyroid Hormone / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D011347:Procollagen / Q000097:blood; D011446:Prospective Studies; D016176:T-Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D010281:Parathyroid Hormone; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide; D014807:Vitamin D; D002762:Cholecalciferol; C097949:1,25-dihydroxyvitamin D; C104450:25-hydroxyvitamin D; D002117:Calcitriol; D002118:Calcium