title: Per oral substitution with 300000 IU vitamin D (Cholecalciferol) reduces bone turnover markers in HIV-infected patients.
abstract: BACKGROUND
  Osteoporosis and bone fractures seem to be higher in HIV-infected Patients compared to the general populations. Moreover, bone turnover markers are increased in patients on antiretroviral therapy and vitamin D deficiency is prevalent in HIV-infected patients. However, the influence of per oral cholecalciferol on bone metabolism in HIV infected patients is not well understood.
  
  
  METHODS
  We measured the bone turnover markers in 96 HIV-infected patients: Bone specific alkaline phosphatase (BSAP), Pyridinoline (PYR), Desoxypyridinoline (DPD) and 25-OH vitamin D. If 25-OH vitamin D was below 75 nnol/L (87/96 patients), 300000 IU cholecalciferol was given per os. 25OH-vitamin D and bone turn over markers were determinded 3 month later. 25 OH-vitamin D was corrected for circannual rythm y'=y+17.875*sin2π/365*day+2.06, whereas bone turnover markers were not corrected. The paired students t-Test was used to compare the two periods. No calcium supplementation or biphosphonate therapy was given.
  
  
  RESULTS
  Corrected 25OH-vitamin D levels increased significantly after supplementation (42.7 ± 26.61 vs. 52.85 ± 21.8 nmol/L, p < 0.001). After supplementation, bone turnover markers were significantly lower. The values decreased for BSAP from 21.31 ± 14.32 to 17.53 ± 8.17 μg/L (p < 0.001), PYR from 74.57 ± 36.83 to 54.82 ± 21.43 nmol/mmol creatinine (p < 0.001) and DPD from 15.17 ± 8.34 to 12.61 ± 5.02 nmol/mmol creatinine (p = 0.01).
  
  
  CONCLUSIONS
  After per oral substitution with cholecalciferol, bone formation as well as bone resorption markers decreased significant. We postulate a protective effect on bone structure with cholecalciferol supplementation.
authors: Department of Medicine, Kantonsspital, Olten, Switzerland. jan.piso@spital.so.ch.
authors: Rein Jan
authors: RJ
authors: Piso
authors: Madeleine
authors: M
authors: Rothen
authors: Jean Pierre
authors: JP
authors: Rothen
authors: Matthias
authors: M
authors: Stahl
authors: Christoph
authors: C
authors: Fux
mesh_terms: D000284:Administration, Oral; D000596:Amino Acids / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001862:Bone Resorption / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D002112:Calcifediol / Q000097:blood; D002762:Cholecalciferol / Q000008:administration & dosage*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy / Q000378:metabolism
chemical_list: D000596:Amino Acids; D015415:Biomarkers; D002762:Cholecalciferol; C015484:pyridinoline; D002112:Calcifediol